J Korean Ophthalmol Soc.  2012 Dec;53(12):1766-1771. 10.3341/jkos.2012.53.12.1766.

Short-Term Clinical Outcomes of Pterygium Treatment with Conjunctival Flap Advancement

• Pak KY
• Lee JS

• KMID: 2216388
• DOI: http://doi.org/10.3341/jkos.2012.53.12.1766

Abstract

PURPOSE
The present study reviewed the surgical outcomes of conjunctival flap advancement with pterygial tissue excision in primary and recurrent pterygium.
METHODS
In a retrospective survey of 169 eyes of 169 patients who underwent pterygial tissue excision and conjunctival flap advancement surgery, after a three-month follow-up minimum, history of pterygium surgery, surgical outcomes, recurrence rates, and complications were evaluated.
RESULTS
The study included 74 male and 95 female patients. The mean age was 56 +/- 11.93 years (range: 31-81 years). One hundred and forty eyes were considered as primary pterygium without history of surgery and 29 eyes were considered as recurrent pterygium. In the cases of primary pterygium, 139 eyes were treated after the surgery without recurrence (success rate: 99.2%) and one recurred case was localized to the sclera. Among the 29 eyes with recurrent pterygium, 26 eyes were treated without recurrence (success rate: 89.7%) and 3 recurred cases were localized to the sclera. There were no significant complications related to the surgical procedures.
CONCLUSIONS
Conjunctival flap advancement surgery with pterygial tissue excision was an effective method in primary and recurrent pterygium treatment and showed low recurrence and minimal complications.

Keyword

Conjunctival flap; Pterygium surgery; Recurrent pterygium

MeSH Terms

Eye
Female
Follow-Up Studies
Humans
Male
Pterygium
Recurrence
Retrospective Studies
Sclera

Figure

• 

  Figure 1 The surgical procedure of advancement conjunctival flap. (A) The pterygium head is dissected from cornea using blade knife, and the pterygium body including subconjunctival tissue is dissected using scissors. (B) Design of superior and inferior conjunctival flap. Surgical incision is made at the nasal and temporal side of sclera bed parallel to cornea limbus. (C) The conjunctival flap is advanced to cover the bare sclera. U-shaped conjunctiva-sclera-conjunctiva suturing was performed to conjoin upper and lower flaps. The center of the flap edge is sutured to the sclera. ×: conjunctiva-sclera-conjunctiva suture ∨: conjunctiva-conjunctiva suture.

• 

  Figure 2 Slit lamp photographs showing the clinical outcome of advancement conjunctival flap for primary pterygium. (A) Preoperatively, thickened, fibrovascular conjunctival tissues involved the limbus and cornea. Two weeks (B) and 3 months (C) after surgery, conjunctival chemosis and injection decreased.

• 

  Figure 3 Slit lamp photographs showing the clinical outcome after advancement conjunctival flap for recurred pterygium (G3). (A) Preoperatively, thickened, inflamed conjunctival tissues involved the limbus and cornea. Two weeks (B) and 3 months (C) after operation, there was no sign of recurrence.

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