Narrow-strip conjunctival autograft for treatment of pterygium.
OBJECTIVE
To determine the efficacy of narrow-strip conjunctival autograft surgery in the treatment of pterygium.


METHODS
Retrospective noncomparative interventional case series.


METHODS
Twenty-one consecutive interventions between 1994 and 2005 in 20 eyes of 18 patients for primary (n = 17 cases) or recurrent (n = 4 cases) pterygia.


METHODS
Surgical excision of the pterygium and conjunctival transplantation with a narrow-strip technique. In all cases, a 2-mm-wide autograft was secured adjacent and posterior to the limbus, leaving a 2- to 3-mm zone of bare sclera between the graft and the anterior margin of the conjunctival wound. All conjunctival margins were secured by suture to bare sclera.


METHODS
Recurrence of pterygium at 12 months.


RESULTS
Mean follow-up after surgery was 41 months (median, 42; range, 4-132). At 1 year and all time points thereafter, 18 of 19 (94.7%) cases were free of recurrence. One patient was lost to follow-up at 4 months, and another died after 9 months of follow-up. The lone recurrence occurred inferiorly in an eye that had undergone an adjacent narrow-strip conjunctival transplantation 6 months previously for a recurrent temporal pterygium. The same patient remains recurrence-free 67 months after inferior pterygium excision and a second narrow-strip autograft surgery.


CONCLUSIONS
Narrow-strip conjunctival autografting appears to be an effective surgical technique in preventing pterygium recurrence. Creating an intervening bare sclera area between the secured conjunctival graft and the anterior margin of the conjunctival wound may be important in preventing recurrence.
Dupps
William J
WJ
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. bjdupps@sbcglobal.net
Jeng
Bennie H
BH
Meisler
David M
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011625:Pterygium / Q000601:surgery*; D012189:Retrospective Studies; D055502:Secondary Prevention; D013536:Suture Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome