Ninety degree conjunctival rotation autograft versus zero and 180 degree rotation autograft for pterygium surgery

OBJECTIVE: To evaluate the safety, efficacy, and recurrence of pterygium following 90 degrees versus zero degrees and 180 degrees rotation autograft for treating primary pterygium.

METHODS: We included in this observational, prospective, and comparative study, 74 patients (47 males, 27 females) with advanced primary pterygium, with a mean age of 47.5 years (range 19-79 years). This study was conducted in Kuwait University Hospital between February 2004 to March 2006. The excision was under local anesthesia using an operating microscope with rotation autograft taken from upper temporal bulbar conjunctiva by total excision, and free transposition to the bare sclera. We treated 38 eyes by 90 degrees rotation, 15 eyes by 0 degree rotation, and 21 eyes by 180 degrees rotation.

RESULTS: With a one-year follow-up, the recurrence rates (regrowth of the pterygium more than 1 mm over the cornea) were 3% in 90 degrees rotation, 28.6% in 0 degree rotation, and 15.8% in 180 degrees rotation (p=0.033). The overall recurrence rate for all rotation autograft surgeries was 10.8%.

CONCLUSION: In this study, all techniques were effective, and 90 degrees rotation autograft is safe and an easy procedure to perform for management of pterygium, with a lower recurrence rate compared with the 0 degree and 180 degrees rotation autograft (p=0.033). The position or the presence of stem cells of the corneal epithelium is not important in the outcome of the pterygium surgery.