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Pak and Lee: Short-Term Clinical Outcomes of Pterygium Treatment with Conjunctival Flap Advancement
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(12): 1766-1771.

Published online: 17 December 2012

DOI: https://doi.org/10.3341/jkos.2012.53.12.1766

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

Kang Yeun Pak, MD, Jong Soo Lee, MD, PhD

Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea.

Address reprint requests to Jong Soo Lee, MD, PhD. Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea. Tel: 82-51-240-7323, Fax: 82-51-242-7341, jongsool@pusan.ac.kr

Received 4 June 2012       Accepted 26 November 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

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.

Keywords: Conjunctival flap, Pterygium surgery, Recurrent pterygium

Figures and Tables

Figure 1
The surgical procedure of advancement conjunctival flap. (A) The pterygium head is dissected from cornea using blade knife, and the pterygium body including subconjunctival tissue is dissected using scissors. (B) Design of superior and inferior conjunctival flap. Surgical incision is made at the nasal and temporal side of sclera bed parallel to cornea limbus. (C) The conjunctival flap is advanced to cover the bare sclera. U-shaped conjunctiva-sclera-conjunctiva suturing was performed to conjoin upper and lower flaps. The center of the flap edge is sutured to the sclera. ×: conjunctiva-sclera-conjunctiva suture ∨: conjunctiva-conjunctiva suture.
jkos-53-1766-g001
Figure 2
Slit lamp photographs showing the clinical outcome of advancement conjunctival flap for primary pterygium. (A) Preoperatively, thickened, fibrovascular conjunctival tissues involved the limbus and cornea. Two weeks (B) and 3 months (C) after surgery, conjunctival chemosis and injection decreased.
jkos-53-1766-g002
Figure 3
Slit lamp photographs showing the clinical outcome after advancement conjunctival flap for recurred pterygium (G3). (A) Preoperatively, thickened, inflamed conjunctival tissues involved the limbus and cornea. Two weeks (B) and 3 months (C) after operation, there was no sign of recurrence.
jkos-53-1766-g003
Table 1
Characteristics of patients
jkos-53-1766-i001

*Values are presented as mean ± SD.

Table 2
Clinical outcome of advancement conjunctival flap according to type of pterygium
jkos-53-1766-i002

*Operated site that is not different from normal appearance (G1); †Fibrovascular tissue in excised sclera (G2), limbus (G3), and cornea (G4).

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