title: Surgical management of double-head pterygium by using a novel technique: conjunctival rotational autograft combined with conjunctival autograft.
abstract: OBJECTIVE
  To describe a novel technique for the surgical management of double-head pterygium and to evaluate its safety and efficacy.
  
  
  METHODS
  A prospective noncomparative interventional case series was conducted. Patients with primary double-head pterygium underwent pterygium excision, followed by conjunctival rotational autograft (CRA) combined with conjunctival autograft (CA). CRA was harvested from the larger pterygium and placed over the bare scleral defect of the smaller pterygium with 180-degree rotation. The bare scleral defect of the larger pterygium was covered with CA harvested from the superior bulbar conjunctiva. Patients were followed up for 1 year, and the outcomes and recurrence rates were noted.
  
  
  RESULTS
  Twenty patients were recruited into the study, of which 7 (35%) were men and 13 (65%) were women. The mean age was 63.8 years. No intraoperative complication was encountered. Postoperatively, there was significant improvement in best-corrected visual acuity (P = 0.005) and reduction in magnitude of astigmatism (P = 0.016). At 1 year after operation, there were 7 cases of recurrence (35%), but 4 were 1 mm. The main postoperative complication was persistent CRA injection in 9 cases.
  
  
  CONCLUSIONS
  CRA combined with CA is a safe alternative in the management of double-head pterygium. Further modifications of the surgical techniques are warranted to decrease prolonged hyperemia of the CRA.
authors: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
authors: Wai-Kwan
authors: WK
authors: Wu
authors: Victoria W Y
authors: VW
authors: Wong
authors: Stanley C C
authors: SC
authors: Chi
authors: Dennis S C
authors: DS
authors: Lam
mesh_terms: D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D011625:Pterygium / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome