CASE REPORTS: PDF OnlyThe Surgical Management of an Advanced Pterygium Involving the Entire CorneaYip, C. C. M.B.B.S.; Lim, L. M.B.B.S., M.Med.(Ophth.), F.R.C.S.(Edin.); Tan, D. T.H. M.B.B.S., F.R.C.S.(G.). F.R.c.Ophth.(U.K.), F.A.M.S.Author Information Singapore National Eye Centre, Singapore. Cornea: May 1997 - Volume 16 - Issue 3 - p 365-368 Buy Abstract Purpose Conjunctival autografting is a well-established surgical procedure to prevent recurrence after pterygium excision. We described a modified technique of harvesting an annular autograft to cover a large conjunctival defect after excision of an extensive primary pterygium that involved three quadrants of the limbus. Methods A 73-year-old Chinese farmer underwent an excision of an advanced right pterygium involving the entire cornea. A free donor graft was then harvested from the remaining superior bulbar conjunctiva to cover the conjunctival defect, which involved approximately three quadrants of limbus. The undersized graft was split down the center to create an annular graft to cover the defect. Results Postoperatively, there has been no recurrence over a total follow-up period of 11 months. Six months after the initial pterygium surgery, he underwent a successful penetrating keratoplasty for residual deep stromal scarring. Visual acuity 5 months after the penetrating keratoplasty remained stable at 6/18. Conclusions This case report shows that a modified technique of conjunctival autografting can be successful in preventing recurrence in an advanced pterygium after excision. Successful visual rehabilitation with a penetrating keratoplasty also was demonstrated in this patient. © Lippincott-Raven Publishers.