Comparison of vertical split conjunctival autograft with and without limbus to limbus orientation in cases of double-head pterygium桝 retrospective analysis

Purpose: The aim of this study is to compare the outcome and complications in patients who underwent double-head pterygium excision with split conjunctival autograft with and without limbus to limbus orientation. Methods: In this retrospective, comparative study, 99 eyes with double-head pterygium which underwent split conjunctival autograft with limbus to limbus orientation (Group 1) and 93 eyes which underwent without limbus to limbus orientation (Group 2) during the period of 2011�16 were included in this study. The primary outcome compared was the recurrence rate. Other complications were included as secondary outcomes. Results: Mean age in group 1 and group 2 were 46.84 +/- 10.78 years and 54.38 +/- 11.44 years respectively. M:F was 36:63 in group 1 and 45:48 in group 2 with a mean follow up of 18.30 +/- 7.48 months in group 1 and 17.04 +/- 9.98 months in group 2. Recurrence was seen in 4 cases in each of the 2 groups with the mean time of recurrence being 7 +/- 2.34 months in group 1 and 6 +/- 2.01 months in group 2. Other complications included graft edema, SCH, graft retraction, granuloma, dellen and graft loss with only graft loss being statistically significant between 2 groups. Conclusion: This study provides data that recurrence rates are not different among patients who undergo split conjunctival graft with and without limbal orientation. The strict adherence to maintaining limbus to limbus orientation while managing double-headed pterygia may not be necessary in all cases, especially in those with large defects following excision.

Clinical Research on Surgical Treatment for Double-Head Pterygium

PURPOSE: To evaluate two surgical methods-amniotic membrane transplantation (AMT) and split-conjunctival grafts (SCG)-for double-head pterygium, with regard to the postoperative outcome and recurrence rate. METHODS: In a total of 16 eyes (14 patients), 7 eyes (6 patients) receiving amniotic membrane transplantation and 9 eyes (8 patients) receiving split-conjunctival grafts were compared to evaluate recurrence and complications. RESULTS: Within the amniotic membrane transplantation group, two eyes (29%) had corneal recurrence, and 3 eyes (43%) had conjunctival recurrence. The mean follow-up period was 21.9+/-3.5 months, and all recurrences were on the nasal side. The average period preceding the corneal recurrences was 7.2+/-1.8 months. Within the split-conjunctival grafts group, the mean follow-up was 13.6+/-2.1 months, and neither the corneal nor conjunctival recurrences were observed. In addition, the eyes of this group were more aesthetically stable, with only one eye exhibiting pseudo-pterygium at the donor site. CONCLUSIONS: In cases of double-head pterygium without contraindication of conjunctival autograft, the split-conjunctival grafts produced fewer recurrences and showed enhanced cosmetic results, as compared to the amniotic membrane transplantation, indicating that the split-conjunctival grafts is the superior choice over amniotic membrane transplantation.