management of pterygium A combined surgical and irradiation technique

128 cases of pterygia were treated by the combined surgical and radiation technique. 19 cases were recurrent, being previously operated upon 1-9 times before, but none was previously irradiated. 11 cases of these recurrent .cases were accompanied with variable degrees of shrinkage of conjunctiva, fibrosis and even ankyloblepahron. These 11 cases were treated by excision of the pterygium and the raw scleral area was covered with autogenous conjunctival flap, mucous membrane grafts from, the lip and cadaver conjunctival grafts, followed by irradiation. The recurrence in these cases was variable and relatively high. The 117 non complicated cases were treated by simple excision of the pterygium and approximation of the conjunctival edges over the raw scleral area followed by superficial X-ray radiation in 6 cases and Sr 90 Beta radiation in 111 cases. The different surgical and irradiation techniques and their results are discussed. In this study, the use of high dose irradiation was avoided. The results of the medium dose fractionated as 1000 rads every 3 days for 3-4 applications with a total dose of 3000-4000 rads, starting from the 5th-7th day after operation was found to give the best result with a recurrence rate of 3.4%. Whereas, the low dose fractionated as 500 rads every other day for 4-6 applications with a total dose of 2000-3000 rads gave a higher rate of recurrence 3.8%