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A Comparison of Anchored Conjunctival Rotation Flap and Conjunctival Autograft Techniques in Pterygium Surgery

Kim, Sung Hyun MD; Oh, Jong-Hyun MD; Do, Jae Rock MD; Chuck, Roy S. MD, PhD; Park, Choul Yong MD

doi: 10.1097/ICO.0b013e3182a73a48
Clinical Science

Purpose: To compare conjunctival autograft and anchored conjunctival rotation flap techniques, in terms of recurrence and complication rates, after performing a primary pterygium surgery.

Methods: Sixty patients who underwent pterygium surgery, which was performed on 1 eye (M:F = 25:35), either using conjunctival autograft (25 eyes) or anchored conjunctival rotation flap (35 eyes) techniques, were followed up postoperatively for a minimum period of 18 months. The anchored conjunctival rotation flap surgery was conducted by designing a conjunctival flap with a similar shape as that of the autograft, but with the preservation of the inferior limbal anchoring point (1 mm) by the incomplete cutting of the limbal area. After rotation of the flap around the anchoring point, the flap was tightened with sutures to cover the bare scleral area. Early postoperative complications, such as flap or graft edema and granuloma formation, were assessed. The recurrence rate of pterygium was evaluated, and a comparison was made between the 2 surgical techniques.

Results: The recurrence rate was 8.0% in the conjunctival autograft group and 8.6% in the anchored conjunctival rotational flap group (P = 0.659). However, the occurrence of flap or graft edema was lower for anchored conjunctival rotational flap surgery (14.3% vs. 72.0%, P < 0.001). No granuloma formation was observed in either group.

Conclusions: The anchored conjunctival rotational flap surgery showed similar pterygium recurrence rates and a lower incidence of flap edema, while enabling simple recognition of flap orientation, compared with the conjunctival autograft technique.

*Department of Ophthalmology, Dongguk University, Ilsan Hospital, Koyang, Kyunggido, South Korea; and

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Reprints: Choul Yong Park, Department of Ophthalmology, Dongguk University, Ilsan Hospital, 814, Siksadong, Ilsan-dong-gu, Goyang, Kyunggido, South Korea 410-773 (e-mail:

Supported partially by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF 2010–0002532), and a core grant from Research to Prevent Blindness (Albert Einstein College of Medicine).

The authors have no conflicts of interest to disclose.

S. H. Kim and J.-H. Oh contributed equally to this study.

Received June 25, 2013

Accepted July 27, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.