Pterygium surgery by double-sliding flaps procedure: Comparison between primary and recurrent pterygia

Abstract

Purpose: This study aimed to evaluate the surgical outcomes of pterygial excision for primary and recurrent pterygia by a single method of pterygia excision combined with two conjunctival flaps. Methods: This retrospective study divided 193 cases of pterygium into the primary (140 cases) and recurrent (53 cases) pterygium groups. Following double-sliding conjunctival transposition flap operation and surgical excision of the pterygium, the success and recurrence rates of pterygial surgery were assessed based on visual acuity and corneal and total astigmatism during follow-up at least 6 months. Results: Both primary and recurrent pterygium groups showed significant improvements in visual acuity and astigmatism (corneal and total) between before and after this procedure. Total astigmatism and success rate of primary pterygium were significantly better than those for recurrent pterygium. Two cases (1.4%) of primary pterygium and four cases (7.5%) of recurrent pterygium developed recurrence, corresponding to a rate of 3.1% (6/193 cases). The success rates significantly make a difference between primary and recurrent groups but did not differ significantly between the first recurrent and over twice recurrent pterygium. However, visual acuity, cornea, and total astigmatism improved significantly after surgery in first recurrent group but not in over twice recurrent group. Conclusion: The double-sliding conjunctival flaps surgery appeared to be a useful method, with a better success rate and lower pterygial recurrence in pterygium surgery. Especially, when pterygium is larger or recurrent type, this technique can be easily covered the bare sclera, as compared to any transposition conjunctival flap operation.

Acupoint Massage plus Recombinant Bovine Basic Fibroblast Growth Factor Ophthalmic Gel and Limbal Stem Cell Transplantation on Visual Quality, Corneal Refraction, and Aesthetic Outcome in Patients with Pterygium

“…Corneal invasion can result in changes in corneal morphology or refractive abnormalities [ 3 ]. If not treated in time, pterygium will gradually expand, which will have a significant impact on the patient's corneal astigmatism and eye movement and even reduce the patient's visual acuity [ 4 , 5 ]. The final treatment of pterygium should achieve the purpose of restoring vision, improving cosmetic effects, and reducing adverse reactions and postoperative recurrence rates.…”

Sliding limbus-conjunctival flaps for minimizing the pterygium recurrence: a prospective tertiary care institute study

“…Generally, our limbal stem cell in health provides a natural barrier for the conjunctival epithelium to grow over the corneal epithelium. Hence, we focused on moving or sliding the surrounding limbal stem cells via the limbus-conjunctival graft to minimize pterygium recurrence [6][7][8][9][10][11].…”

Pterygium excision with rotational conjunctival flap - a simple and effective method

“…Other flap techniques such as single/double sliding, transpositional, traditional and modified mini flap also show low recurrence rate (1.4% -10.3%). [18][19][20][21] Doublesliding conjunctival flaps surgery is useful to cover bare sclera when pterygium is larger or recurrent type. 19 Studies done in our population show recurrence rate following CAG, AMT and conjunctival flap varying from 3.3% to 25%, 7.84% to 10% and 6.6% to 9.76% respectively.…”

“…[18][19][20][21] Doublesliding conjunctival flaps surgery is useful to cover bare sclera when pterygium is larger or recurrent type. 19 Studies done in our population show recurrence rate following CAG, AMT and conjunctival flap varying from 3.3% to 25%, 7.84% to 10% and 6.6% to 9.76% respectively. [4][5][6]22,23 Shakil et al used anchored conjunctival flap technique in which flap was anchored at 1mm frill of limbal conjunctiva and secured at scleral bed with 7/0 polyglactin (vicryl) sutures.…”