Sliding conjunctival flap for the treatment of primary pterygium.

Abstract

The major problems after pterygium removal are recurrence and complications of the therapy. The authors investigated a simple surgical treatment without adjunctive therapy for primary pterygium. Patients eligible to be included in the study were identified from a pterygium treatment log. They represent consecutive cases over a 6 1/2-year period, all of whom had been treated by one surgeon using a superior, sliding, conjunctival flap to cover the pterygium defect. An attempt was made to obtain follow-up of at least 1 year for each patient. Two hundred fifty-eight eyes in 236 patients were included in the study. Two hundred twenty-two eyes (86%) were able to be followed by either record review or re-examination. Seven pterygia (3.2%) recurred, all identified by record review, with no recurrences identified by re-examination. Recurrences were more likely after early postoperative flap retraction (5 of 7 recurrences) and recurrence occurred at a mean interval of 4.3 months (range, 1.5-11 months) after surgery. Symptomatically, the patients were comfortable, and the cosmetic result was good. This study indicates that this simple surgical procedure for the treatment of primary pterygium should be evaluated further by controlled clinical trials.