Management of double-head pterygium with conjunctival autograft and primary closure

Double-headed pterygia are rare and present the surgeon with challenges. This case report illustrates the surgical management and the course of healing in a double-head pterygium patient.

A 53-year-old man was referred to our eye hospital with a double-head pterygium of the right eye. During the follow-up examinations, 1 and 3 years later stable findings were found. Five years after initial referral we saw a progression of the double-head pterygium and the patient explained a worse visual acuity. The nasal and temporal pterygium was resected and conjunctival autograft transplantation, and a primary closure was performed, respectively, for the bulbar conjunctival reconstruction. After the surgery, a reduction in the inflammation and healing of the conjunctival lesion could be seen. At the 12-month follow-up, there was no sign of recurrence or any postoperative complication.

A surgical excision combined with conjunctival autograft transplantation and primary closure in a one-time intervention seems to be effective and economical for the treatment of double-head pterygium.