title: Reducing postoperative pterygium recurrence: comparison of free conjunctival auto-graft and conjunctival rotation flap techniques.
abstract: OBJECTIVE
  To compare the recurrence of pterygium between free conjunctival auto-graft and conjunctival rotation flap following simple surgical excision of pterygium.
  
  
  METHODS
  Quasi-experimental study.
  
  
  METHODS
  Shifa Foundation Community Health Clinic, Shifa College of Medicine, Islamabad, from January to November 2012.
  
  
  METHODS
  Fifty seven cases aged above 18 years, with a pterygium corneal encroachment of ³ 2 mm which was responsible for visual disability or was cosmetically undesirable were recruited for the study and randomly assigned to conjunctival auto-graft group and conjunctival rotation flap group. Cases with a history of glaucoma or glaucoma suspect, prior pterygium surgery, pterygium with concurrent ocular surface and lid disease, conjunctival inflammation and scarring, pseudo-pterygium or collagen vascular disease were excluded. After simple pterygium excision conjunctival auto-graft group (n=26) cases received a free conjunctival flap was transplanted, while conjunctival rotation flap group (n=31) cases received a conjunctival rotation flap. All cases were followed-up for 6 months after surgery for recurrence and complications. Frequency distribution and significance of association of recurrence using Fisher's exact test and Mann-Whitney U-test was carried out using Statistical Package for Social Sciences (SPSS) version 20.
  
  
  RESULTS
  The median (and inter-quartile range) age and surgery duration in conjunctival auto-graft group and conjunctival rotation flap group were 60 (51.50-63.00) and 57 (45.00-60.00) years, 28.50 (27.00-30.50) and 16.00 (15.00-17.00) minutes respectively. Recurrence was seen in 2 (7.96%) and 3 (9.76%) cases in auto-graft and rotation flap groups respectively. No significant difference was seen in postoperative complications between the two groups (p=0.60).
  
  
  CONCLUSIONS
  The surgical time for conjunctival rotation flap procedure is less as compared to free auto-graft, while their recurrence and complications are comparable.
authors.affiliation: Department of Ophthalmology, Shifa College of Medicine, Islamabad.
authors.forename: Waseem
authors.initials: W
authors.lastname: Akhter
authors.affiliation: Department of Ophthalmology, Shifa College of Medicine, Islamabad.
authors.forename: Ali
authors.initials: A
authors.lastname: Tayyab
authors.affiliation: Department of Ophthalmology, Shifa College of Medicine, Islamabad.
authors.forename: Ayisha
authors.initials: A
authors.lastname: Kausar
authors.affiliation: Department of Ophthalmology, Shifa College of Medicine, Islamabad.
authors.forename: Amena
authors.initials: A
authors.lastname: Masrur
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011184:Postoperative Period; D011625:Pterygium / Q000517:prevention & control / Q000601:surgery*; D012008:Recurrence; D013524:Surgical Flaps; D014182:Transplantation, Autologous / Q000379:methods*
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin