Sutureless and glue-free limbal-conjunctival autograft in primary and recurrent pterygium: A pilot study

Purpose: To evaluate and analyze the outcomes of sutureless and glue?free limbal?conjunctival autografting in cases of primary as well as recurrent pterygium. Methods: This prospective interventional study was carried out between February 2019 and February 2020 at a tertiary care hospital in North India. A total of 70 patients with pterygium underwent sutureless and glue?free limbal?conjunctival autograft. The patients were divided into two groups: group 1 patients with primary pterygium (n = 45), group 2 patients with recurrent pterygium (n = 25). The patients were followed up till 12 months postoperatively. Results: The mean age of the patients in group 1 and group 2 was 37.04 ± 8.69 years and 32.52 ± 6.49 years, respectively (P = 0.04). Postoperatively, no recurrence was recorded in group 1. Recurrence was noticed in two patients (8%) of group 2. The BCVA changed from 78.73 ± 9.86 letters to 80.15 ± 7.29 letters (P = 0.45) and from 79.6 ± 6.44 letters to 79.8 ± 5.86 letters (P = 0.45) in group 1 and group 2, respectively. Graft edema was found in seven (15.55%) cases of group 1 and four (16%) cases of group 2. Graft retraction was found in two (4.44%) cases of group 1 and three (12%) cases of group 2. Conclusion: Sutureless and a glue?free limbal?conjunctival autograft is a safe and effective treatment option for primary as well as recurrent pterygium.

Pterigión recidivante y sus alternativas terapéuticas / Recurrent pterygium and its therapeutic alternatives

RESUMEN El pterigión se trata de un crecimiento fibrovascular de morfología triangular que se extiende desde la conjuntiva hacia la córnea. Está clasificado dentro de las degeneraciones no involutivas o tumoraciones epiteliales benignas corneales y se presenta en el 10,2 por ciento de la población. El tratamiento quirúrgico es el más indicado, y tiene una tasa de recidiva independientemente de la técnica quirúrgica utilizada del 10,7 por ciento; esta tasa de recidiva se evidencia por la neovascularización y el tejido cicatrizal antes de los dos meses después de la cirugía. Lo anterior ha incentivado la investigación de nuevos tratamientos que disminuyan esta complicación, por lo que el objetivo de esta revisión bibliográfica fue la búsqueda de alternativas terapéuticas para el pterigión recidivante. Se realizó una búsqueda automatizada sobre el tema, utilizando la plataforma Infomed, cuya información fue resumida para la elaboración del informe final. Concluimos que existen diferentes tratamientos adyuvantes para disminuir la tasa de recurrencia, y es necesario realizar estudios donde se determine el tiempo y la frecuencia en la aplicación de estos para obtener resultados más efectivos en su uso(AU)

ABSTRACT Pterygium is a fibrovascular growth of triangular shape that extends from the conjunctiva to the cornea. It has been classified as a noninvolutionary degeneration or benign corneal epithelial tumor which affects 10.2 percent of the population. The treatment most commonly indicated is surgery, which has a recurrence rate of 10.7 percent, irrespective of the surgical technique used. Recurrence takes the form of neovascularization and scar tissue within two months after surgery. This has fostered research into new treatments to reduce this complication. The objective of the present bibliographic review was precisely to search for therapeutic alternatives for recurrent pterygium. An automated search was conducted about the topic on the platform Infomed. Data were summarized to write the final report. We concluded that there are several adjuvant treatments to reduce recurrence, and it is necessary to carry out studies determining the time and frequency of their application to obtain more effective results(AU)

Differences in clinical characteristics and laboratory parameters of primary and recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#Pterygium is a common conjunctival disease which is mainly attributed to chronic ultraviolet light exposure. Previous studies have focused primarily on the clinical characteristics, surgical management and the pathogenesis of pterygium, but the differences between primary pterygium and recurrent pterygium have been less frequently documented. This article reviews the differences in clinical manifestations, histopathological findings, and laboratory parameters between primary pterygium and recurrent pterygium and summarises the latest findings regarding these differences.

Double-Layered Conjunctival Autograft and Amniotic Membrane Transplantation to Treat Restrictive Esotropia and Hypotropia

PURPOSE: To report a case of double-layered conjunctival autograft and amniotic membrane transplantation for the effective treatment of esotropia and hypotropia after removal of the recurrent pterygium. CASE SUMMARY: A 58-year-old male who had pterygium surgery of the right eye twice presented with diplopia on right gaze for 3 months. At the first visit, he had orthotropia in the primary position and right esotropia of 12 prism diopters (PD) on right gaze with limited abduction of -1 in the right eye. Fourteen months later, deviation was aggravated by esotropia of 30 PD and 12 PD of right hypotropia in the primary position at distance, and esotropia of 35 PD and 12 PD of right hypotropia at near with limited abduction of -2 and supraduction of -3 in the right eye. The patient complained of diplopia at all gazes and demonstrated chin-up posture. The conjunctival edge was recessed near the medial canthus and fornix, preventing conjunctival autograft after removal of subconjunctival scar tissue. Thus, 5 mm right medial rectus recession and additional half-sized conjunctival autograft were performed after amniotic membrane transplantation. The patient than showed no diplopia and orthotropia at both distance and near, with limited adduction of -1 in the right eye. He experienced no recurrence during 7 months of follow-up. CONCLUSIONS: To prevent poor epithelial regeneration and dehiscence of graft in the patients with severe restrictive strabismus and very extensive conjunctival defect, double-layered conjunctival autograft and amniotic membrane transplantation may be effective for the treatment of severe esotropia and hypotropia.

The Effect of Inferior Conjunctival Transposition Flap for Recurrent Pterygium

PURPOSE: In the present study, the effect of the inferior conjunctival transposition flap in patients with recurrent pterygium was evaluated. METHODS: This study included 60 patients (63 eyes) that received pterygium surgery with inferior conjunctival transposition flap and diagnosed with recurrent pterygium. The inferior conjunctival transposition flap obtained from lower bulbar conjunctiva was secured with 8-0 VICRYL® after removal of recurrent fibrovascular tissues. This study was retrospectively reviewed for recurrence and postoperative complications in patients with a minimum follow-up period over 6 months. RESULTS: The mean follow-up period was 5 years and 8 months (range; 6 months to 14 years). Corneal recurrence occurred in 4 eyes (6.3%) and conjunctival recurrence was observed in 2 eyes (3.1%) among a total of 63 eyes. Conjunctival recurrence was not the progressive type and limited to the limbus and suture site. One case of corneal recurrence required additional symblepharolysis and auto conjunctival graft. Although mild flap congestion, hemorrhage and granuloma were observed, these cases improved during the follow-up period. CONCLUSIONS: The inferior conjunctival transposition flap procedure can be regarded as an effective surgical treatment option for recurrent pterygium.

Comparison of different concentration mitomycin C in the treatment of recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To compare the clinical efficacy of treatment on recurrent pterygium using different concentration mitomycin C ( MMC) in the pterygium excision operation combined with the corneal limbal stem cell autografting ( CLSCA) .METHODS: Sixty patients ( 65 eyes ) with recurrent pterygium were randomly divided into three groups. All cases were accepted CLSCA, 21 patients (22 eyes) were given 0. 15g/L MMC during operation, 20 patients ( 22 eyes) were given 0. 25g/L MMC during operation, 19 patients ( 21 eyes ) were given 0. 4g/L MMC during operation. The patients were followed up for 6mo to 2a.RESULTS:The recurrent rates of the three groups were 9%, 5%, 5% respectively. There was no statistically significant differences (P>0. 05). The complication rates of the three groups were 5%, 36%, 33% respectively. There were statistically significant differences (P<0. 05). CONCLUSlON: The treatment to the recurrent pterygium using low concentration MMC has the similar recurrence rates, but the complication rate was lower, it is an ideal operation method, and it is worth popularization and application.

Comparison of conjunctival graft thickness after primary and recurrent pterygium surgery: Anterior segment optical coherence tomography study.

Objective: The objective of the following study is to compare the conjunctival graft thickness measured with anterior segment optical coherence tomography (OCT) after primary and recurrent pterygium excision. Design: Prospective, interventional and comparative study. Participants: A total of 20 eyes of 20 patients with primary pterygium (primary group) and 20 eyes of 20 patients with recurrent pterygium (recurrent group) were enrolled. Materials and Methods: All patients underwent pterygium excision with conjunctival autograft transplantation. Conjunctival graft thickness was measured at 1 week, 1 month and 3 months after surgery using the Visante‑OCT (Carl‑Zeiss Meditec, Dublin, CA, USA). Main outcome measure was the mean conjunctival thickness determined as the mean of three measurements at 1, 2 and 3 mm posterior to the scleral spur. Results: There were no statistically significant differences in age, sex, or laterality between the groups. Mean thickness of the graft in primary and recurrent groups, respectively, was 430 ± 127 μm and 461 ± 178 μm at 1 week after surgery (P = 0.587), 114 ± 19 μm and 162 ± 48 μm at 1 month after surgery (P = 0.001) and 109 ± 15 μm and 107 ± 18 μm at 3 months after surgery (P = 0.726). Conclusion: The findings revealed that conjunctival thickness after primary or recurrent pterygium excision was greatest at 1 week after surgery and continued to decrease for up to 3 months. Mean graft thickness differed significantly between the two groups only at 1 month after surgery.

Comparison of conjunctival graft thickness after primary and recurrent pterygium surgery: Anterior segment optical coherence tomography study.

Objective: The objective of the following study is to compare the conjunctival graft thickness measured with anterior segment optical coherence tomography (OCT) after primary and recurrent pterygium excision. Design: Prospective, interventional and comparative study. Participants: A total of 20 eyes of 20 patients with primary pterygium (primary group) and 20 eyes of 20 patients with recurrent pterygium (recurrent group) were enrolled. Materials and Methods: All patients underwent pterygium excision with conjunctival autograft transplantation. Conjunctival graft thickness was measured at 1 week, 1 month and 3 months after surgery using the Visante‑OCT (Carl‑Zeiss Meditec, Dublin, CA, USA). Main outcome measure was the mean conjunctival thickness determined as the mean of three measurements at 1, 2 and 3 mm posterior to the scleral spur. Results: There were no statistically significant differences in age, sex, or laterality between the groups. Mean thickness of the graft in primary and recurrent groups, respectively, was 430 ± 127 μm and 461 ± 178 μm at 1 week after surgery (P = 0.587), 114 ± 19 μm and 162 ± 48 μm at 1 month after surgery (P = 0.001) and 109 ± 15 μm and 107 ± 18 μm at 3 months after surgery (P = 0.726). Conclusion: The findings revealed that conjunctival thickness after primary or recurrent pterygium excision was greatest at 1 week after surgery and continued to decrease for up to 3 months. Mean graft thickness differed significantly between the two groups only at 1 month after surgery.

Pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation on recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

To discuss the effective method of decreasing the postoperative recurrence rate of recurrent pterygium. ●METHODS:Totally 126 cases (126 eyes) with recurrent pterygium were randomly divided into A group (56 cases) and B group ( 70 cases ). Group A was treated by pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation, group B was treated by amniotic membrane transplantation. The followed-up time after surgery was 6-24mo. ●RESULTS:ln group A, postoperative 5-7d (average 5. 62± 1. 38d), cornea epithelium was repaired. ln group B, postoperative 7- 10d ( average 7. 38 ± 1. 12d), the corneal wound was healed. There was statistical significant difference between two groups (t = 4. 307,P ●CONCLUSlON: lt is suggested that pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation is effective in the treatment of recurrent pterygium.

The Clinical Effect of Micro-Multiporous Expanded Polytetrafluoroethylene Insertion for Recurrent Pterygium

PURPOSE: To investigate the clinical effect of micro-multiporous e-PTFE insertion for severe recurrent pterygium with symblepharon. METHODS: The present study included a total of 13 cases of recurrent pterygium associated with symblepharon, motility restriction and diplopia which had undergone micro-multiporous e-PTFE insertion after pterygium excision, 0.02% mitomycin C application, human amniotic membrane transplantation (AMT) and/or conjunctivo-limbal autograft (CLAU) between September 2010 and February 2011. One month after surgery, the inserted e-PTFE was removed. Recurrence of pterygium and symblepharon, motility restriction, diplopia and injection of ocular surface were evaluated for 11.92 +/- 1.32 months of mean follow-up period. RESULTS: Pterygial recurrence was not observed in 12 out of 13 eyes, and the 1 eye which recurred showed conjunctival recurrence. No postoperative symblepharon recurrence was observed in any of the 13 eyes. Diplopia and motility restriction disappeared in 11 out of 13 eyes, and were improved in the other 2 eyes. VAS (Visual Analogue Scale) injection scores in the wound site decreased after surgery in all patients. CONCLUSIONS: Micro-multiporous e-PTFE insertion combined with mitomycin C application, AMT and CLAU can be a useful surgical method to lower the postoperative recurrence rate and to improve the pterygium-related symptoms in severe recurrent pterygium.

Efficacy of preoperative injection versus intraoperative application of mitomycin in recurrent pterygium surgery.

Purpose: To determine the efficacy of preoperative subconjunctival injection of mitomycin C a day before surgery in the management of recurrent pterygium. Materials and Methods: Randomized comparative case series. Fifty eyes with recurrent pterygium were randomly divided into two groups; the mitomycin injection group (25 eyes) and the mitomycin application group (25 eyes). The mitomycin injection group underwent preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before bare sclera pterygium excision surgery. The mitomycin application group underwent bare sclera pterygium excision with topical application of mitomycin C (same concentration). Results: At one year of follow-up, 24 of 25 eyes (96%) in the mitomycin injection group and 23 of 25 (92%) eyes in the mitomycin application group were free of recurrence. The difference was statistically insignificant. As regards postoperative complications, delayed epithelization (more than two weeks) occurred in two eyes (8%) in the mitomycin injection group and in one eye (4%) in the mitomycin application group. Scleral thinning was reported in one eye (4%) in the mitomycin application group which resolved within three weeks after surgery, no other serious postoperative complications were reported. Conclusion: Preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before pterygium surgery is a simple and effective modality for management of recurrent pterygium. It has the advantage of low recurrence and complications’ rate.

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

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.

Primary pterygium surgery –comparsion of limbal conjunctival autografting versus intra- operative mitomycin-C.

Pterygium is a fibro vascular encroachment of the conjunctival tissue on to the cornea, causing variable degree of ocular morbidity. Various surgical modalities have been developing to decrease the recurrence. The idea of study is to compare the relative efficacy of two well known procedures i.e. conjunctival autografting and intra-operative Mitomycin –C (0.02%) with reference to recurrence and complication rate.

Estudio comparativo del uso de mitomicina C en el pterigium recidivante / Comparative study of the use of mitomycin C in recurrent pterygium

El pterigium constituye un problema en la práctica oftalmológica por su alta prevalencia y elevada frecuencia de recidiva. El propósito de este estudio fue el de comparar la técnica quirúrgica de injerto autólogo de conjuntiva con células límbicas más mitomicina C, con la de injerto de membrana amniótica con mitomicina C, en pterigium recidivante, en cuanto a la tasa de recidiva, complicaciones posoperatorias inmediatas, y tiempo libre de recidiva (meses). Se realizó un ensayo clínico controlado prospectivo con n= 57 pacientes portadores de pterigium recidivante. Se conformaron 2 grupos: grupo 1, injerto de conjuntiva antólogo con células límbicas más mitomicina C; y el grupo 2, injerto de membrana amniótica más mitomicina C. Se comparó el comportamiento de las técnicas empleadas a partir de sus resultados. El seguimiento fue ± de 1-6 meses. La agudeza visual mejoró en 60 por ciento de los casos. La recidiva fue de 2 por ciento para el grupo 1 y de 6 por ciento para el grupo 2. El método de injerto conjuntival con limbo resultó más efectivo para el tratamiento del pterigium recidivante. Él método de membrana amniótica constituye una alternativa para el tratamiento de casos en los cuales no sea viable la aplicación de de injerto antólogo.

Pterygium is a problem in ophthalmology practice because of its high prevalence and frequency of recurrence. The objectives of this study was to compare the surgical technique of autologous conjuctival graft with limbal cells plus mitomycin C with that of amniotic membrane graft treated with mitomycin C in recurrent pterygium in terms of recurrence rates, immediate postoperative complications and recurrence-free time (months). A prospective controlled clinical assay was carried out in 57 patients suffering recurrent pterygium. They were divided into two groups; the group 1 that had autologous conjuctival graft with limbal cells plus mitomycin C, and the group 2 with amminotic membrane graft plus mitomycin C. The used techniques were compared on the basis of their results. The follow-up period extended from one to six months. Visual acuity improved in 60 percent of cases. Recurrence occurred in 2 percent of cases in group 1 and 6 percent in group 2. The conjunctival graft with limbal cells method was more effective for the recurrent pterygium treatment. The amniotic membrane method constitutes an alternative therapy for cases in which autologous graft is not applicable.

Clinical Results After Application of Bevacizumab in Recurrent Pterygium

PURPOSE: To clinically establish the effectiveness and safety of bevacizumab on recurrent pterygium. METHODS: Twenty patients with recurrent pterygium were given a subconjunctival injection of 0.3 cc bevacizumab, and were evaluated for periodic clinical results at 1 week, 2 weeks, 4 weeks, and every month thereafter. The patients were also evaluated for clinical results and complications. RESULTS: Of recurrent pterygium patients with bevacizumab injection, the conjunctival injection decreased maximally after 1 to 2 weeks, but significantly increased at 4 weeks (above the lowest level measured at 1 to 2 weeks), and no patient presented conjunctival injection above the pre-injection level at 3 months, except in 2 cases. Two weeks after the injection, ICG anterior segment angiography revealed a significant decrease (30.14+17.69%) in vessel thickness of the pterygium 2 weeks after the bevacizumab injection compared to before the injection. There had been no cases of progression of pterygium, and no ocular or systemic complications due to bevacizumab. CONCLUSIONS: As shown above in the results, subconjunctival injection of 0.3 cc bevacizumab decreased the conjunctival injection and effectively suppressed any further progression of pterygium. Thus, bevacizumab subconjunctival injection appears to be effective in recurrent pterygium treatment instead of surgical methods.

Superior-inferior Sliding Conjunctival Flap for Pterygium with a Fibrin Tissue Adhesive (Tisseel(R))

PURPOSE: To report the clinical effect of a superior-inferior sliding conjunctival flap for pterygium using fibrin tissue adhesives (Tisseel(R); Baxter Healthcare Corporation, Glendale, CA) instead of sutures. METHODS: After the primary pterygial tissue was removed from the sclera, a superior-inferior sliding conjunctival flap was created. The fibrin tissue adhesive (Tisseel(R)) was composed of two solution types: fibrinogen containing aprotinin solution and a CaCl solution containing thrombin. The two solutions with 27 G needle were applied on the bare sclera in sequence, and the conjunctival flap was attached into the bare sclera within 5 seconds. We performed this procedure with a fibrin tissue adhesive instead of sutures in three patients, and follow-up for recurrence of pterygium and postoperative complications. RESULTS: The superior-inferior sliding conjunctival flaps were attached into the bare sclera in all patients using fibrin tissue adhesives. We didn't find any significant postoperative complications such as ocular pain, epiphora, foreign body sensation, wound defect, or dehiscence. CONCLUSIONS: A superior-inferior sliding conjunctival flap constructed with fibrin tissue adhesives should be a useful management tool for the inhibition of the recurrence of pterygial.

Corneo- Conjunctival Auto Grafting in Pterygium Surgery

To evaluate the efficacy of conjunctival auto grafting in surgical management of primary and recurrent pterygium, the record of 150 patients comprising 47 females and 103 males who underwent corneocunjunctival auto graft transplant surgery for primary and recurrent pterygia from 1997 to 2003 was reviewed retrospectively. Follow up was done for six months after the surgery. Recurrence of pterygium was considered as failure. All grafts were transplanted promptly. Recurrence was noted in four patients (2.6%). Mild discomfort in the immediate post-operative period was noted in all the patients. Donor site healed without any complication in all the patients.The results indicate that corneo-conjunctival autograft transplantation is an effective treatment for management of both primary & recurrent pterygia.

The Clinical Efficacy of Amniotic Membrane Transplantation and Limbal-Conjunctival Autograft in Patients with Recurrent Pterygium or Pseudopterygium

PURPOSE: To evaluate the clinical efficacy of amniotic membrane transplantation and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium, the results of 15 eyes of 14 patients were analyzed. METHODS: Total 10 cases of recurrent pterygium and 5 cases of pseudopterygium were surgically managed during June 1998 to July 2000. After excision of pterygium, amniotic membrane was attached on the bare sclera and limbal-conjunctival autograft was transplanted over the amniotic membrane. Mean follow-up period was 47.2 week and all patients were examined for recurrence, which was graded from G0(no vessel) to G3(fibrotic tissue invading the limbus). RESULTS: 12 out of 15 cases(rate 80%) showed no recurrence(grade 0). 1 case of grade 2 recurrence and 2 cases of grade 3(total 3 cases) were observed(rate 20%). Reoperation was performed on 2 cases of grade 3 recurrence. There was no further recurrence necessitating additional reoperation. 1 case of limbal graft was detached and removed. The operation time of this more prolonged than the other procedures, but there were no significant complications. CONCLUSION: Amniotic membrane and limbal-conjunctival autograft for patients with recurrent pterygium or pseudopterygium reconstructed complete ocular surface with less recurrence. Therefore, we recommend this surgical approach as a safe and effective method for the treatment of complicated cases of pterygium.

Treatment of recurrent pterygium treated by microsurgical management / 中华显微外科杂志

Objective To compare the therapeutic effects of recurrent pterygium treated by microsur- gical management.Methods Sixty-two cases(67 eyes)with recurrent pterygiumwere randomly divided into limbal stem cell autograft transplantation comblined with mitomycin C(34 cases38 eyesand limbal stem cell autograft transplantation(28 cases29 eyes)The post operative follow-up period was 6 to 30 months.Re- suits One eye recurrence was noted in the trial groupthe recurrent rate was 2.63%Three eyes recurrence was noted in the control groupthe recurrent rate was 10.34%There was statistical significant difference be- tween two groups(P0.05).Conclusion Limbal stem cells autograft transplantation combined with mitomycin C can decrease the recurrent rate.It is an ideal methods of recurrent pterygium surgical procedureis worth spreading.

Postoperative Recurrence Rate of Scleral Fixation Technique and Bare Scleral Technique in Primary Pterygium Operation

Pterygium is a common surgical ocular disease which recurs frequently postoperatively. Numerous different techniques have been developed for the successful surgical treatment of pterygium. It was theorized that the pterygium recurrence after surgery would be prevented if scar tissue is formed on the bare sclera and if the corneal epithelium heals before the conjunctival epithelium reaches the limbus. We compared the recurrence rate of pterygium and complications after bare sclera technique with those after scleral fixation technique by which remaining conjunctiva was anchored tightly to the adjacent sclera with sutures. In the first group, 94 patients (103 eyes) operated by scleral fixation technique were composed of 45 male and 49 female. Their mean age was 57.2+/-9.7 years and mean follow-up period was 12.50+/-2.53 months. In the second group, 96 patients(101 eyes) operated by bare sclera technique were composed of 47 male and 49 female. Their mean age was 56.3+/-9.2 years and mean follow-up period was 12.12+/-2.41 months. The recurrence rate was 9.7%(10 eyes) in scleral fixation technique group and 32.7%(33 eyes) in bare sclera technique group. This difference was statistically significant(p<0.05). A case of postoperative scleromalacia was observed in the former group. The scleral fixation technique (as modified bare sclera technique) seems to be more effective for reducing postoperative recurrence of primary pterygium than simple bare sclera technique.