Combination grafting procedure shows efficacy for double-head pterygium

Performing conjunctival rotational autograft combined with conjunctival autograft appears effective for managing patients' double-head pterygium, according to a prospective study.

Wai-Kwan Wu, FRCS, and colleagues reviewed outcomes for 20 patients treated for primary double-head pterygium at a mean age of 63.8 years. Surgeons first performed pterygium excision followed by conjunctival rotational autograft (CRA) combined with conjunctival autograft (CA), according to the study, published in the October issue of Cornea.

"CRA was harvested from the larger pterygium and placed over the bare scleral defect of the smaller pterygium with 180° rotation. The bare scleral defect of the larger pterygium was covered with CA harvested from the superior bulbar conjunctiva," the authors said.

Postoperatively, best corrected visual acuity had significantly improved (P = .005) and astigmatism had significantly decreased (P = .016).

No patients experienced intraoperative complications, the authors noted.

At 1 year postop, pterygia had recurred in seven patients (35%), four of which were 1 mm in size. "The main postoperative complication was persistent CRA injection in nine patients," the authors said.

"Further modifications of the surgical techniques are warranted to decrease prolonged hyperemia of the CRA," they said.