Inferior conjunctival autografting for pterygium surgery: an alternative way of preserving the glaucoma filtration site in far western Nepal

Abstract

Arjun Shrestha1, Anand Shrestha2, Sujata Bhandari1, Nhukesh Maharjan3, Deepak Khadka1, Suresh Raj Pant1, Bidya Prasad Pant11Geta Eye Hospital, Dhangadhi, 2Tribhuvan University Teaching Hospital, Kathmandu, 3Tilganga Institute of Ophthalmology, Kathmandu, NepalBackground: The purpose of this study was to evaluate the outcome of pterygium excision with inferior conjunctival autografting for primary pterygium.Methods: This was a prospective noncomparative interventional case series study enrolling 50 eyes of 50 patients with primary pterygium between November 1, 2010 and October 30, 2011. All patients underwent the standard surgical technique for pterygium excision with inferior conjunctival autografting. The sampling method was purposive. The study variables were complications of surgery and recurrence rates during a follow-up period of 6 months.Results: The mean age of the patients was 43 ± 7.97 (range 26–64) years. Grade 1 pterygium comprised 64% while grade 2 pterygium comprised 36% of cases. The mean size of pterygium was 3.2 ± 0.60 mm. Minor complications did occur, but only 4% required resuturing. Recurrence occurred in two eyes (4%) which we detected 3 months after surgery in both cases. We observed conjunctival scarring at the donor site in four eyes (8%); however, there was no symblepharon formation or restriction of upgaze.Conclusion: Inferior conjunctival autografting is an effective technique with a low recurrence rate. This is a useful technique when it is not possible or desirable to use the superior conjunctiva as a donor source. It is an especially good option for preserving the glaucoma filtration site for the future.Keywords: inferior, conjunctival, autografting, pterygium surgery, recurrence