Removal of Tenon fortified by conjunctival-limbal autograft in treatment of pterygium

Int Ophthalmol. 2017 Aug;37(4):813-818. doi: 10.1007/s10792-016-0341-1. Epub 2016 Sep 9.

Abstract

Purpose: To describe a simple and effective technique for the prevention of pterygium recurrence.

Methods: This is a retrospective consecutive single-center case series with recurrence rate as the main outcome measure. Dissection of the conjunctiva, the Tenon's layer, and the sclera was continued up to the insertion of medial rectus. The exposed Tenon's layer was excised for 2 to 3 mm. The entire free edges of the conjunctiva was tacked firmly to the sclera. The conjunctival-limbal graft was sutured firmly to the sclera, recipient limbus, and to the conjunctiva incorporating the reciprocal edges.

Results: We report findings in a total of 36 patients, with 20 (%55.5) males and 16 (%44.4) females. Median age of the patients was 44.5 years (range 16-80). The mean follow-up period was 23.1 ± 6.5 months. The mean size of pterygium in mm length was 3.8 ± 0.7. Recurrence did not occur in any patient. Diplopia was not reported by any patients.

Conclusions: Conjunctival-limbal autograft combining with selective exicison of Tenon's layer but without damage to any essential tissue such as the semilunar fold or Tenon's capsule pulley is a relatively simple and effective procedure.

Keywords: Conjunctival-limbal autograft; Pterygium; Recurrence; Tenon’s layer.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autografts
  • Conjunctiva / transplantation*
  • Corneal Transplantation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Limbus Corneae / surgery*
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures / methods*
  • Pterygium / surgery*
  • Recurrence
  • Retrospective Studies
  • Secondary Prevention / methods*
  • Tenon Capsule / surgery*
  • Treatment Outcome
  • Young Adult