Primary Pterygium Removal With Rotating Conjunctival Flap, Adjunct Amnion: A Novel Technique

To evaluate the feasability, safety and efficacy of a combined procedure for primary pterygiym removal

The Laservision Clinical and Research Institute, Athens, Greece

8 cases were evaluated in a consective case series. The all suffered from a medical treatment intractable and symptomatic pterygium. A novel surgical technique was employed aiming in the rapid recover, the avoidance of cytotoxic agents such as mitomycin C, and the elimination-if possible- of the potential for recurrence. 

A conjunctival flap of 4mm vertical and 12mm horizontal harvested from the superior cornea, rotated to fill the removed pterygium void, sutured to the remaining conjunctival borders. The rotating flap gap is re-opposed as well with 10-nylon sutures. Freeze-dryed amnion of 30mm X 30mm was sutured in the peripheral conjunctival so to create a uniform biological therapeutic contact lens over the entire exposed ocular surface.

With a 16 month average follow-up (12-22 months) all cases had pterygium disease resolution, no recurrence, acceptable aesthetic result and minimal perioperative discomfort. Conreal astigmatims was reduced by an average of 1.25 D ( 0.75 to 1.75). The bandage 22mm contact lens was removed by week 3 in all cases and postoperative treatment of dexamethasone/antibiotic solution as well. All specimens removed confirmed histopathologically the original clinical diagnosis of pterygium.

We introduce herein a small consecutive case series of intractable pterygiae, managed effectively and with a high safety profile with a novel rotating conjunctival flap technique.