Conjunctival rotation autograft for pterygium. An alternative to conjunctival autografting

Ophthalmology. 1999 Jan;106(1):67-71. doi: 10.1016/S0161-6420(99)90006-4.


Objective: To determine the safety and efficacy of conjunctival rotation autografting (CRA) as an alternative to conventional conjunctival autograft after pterygium excision.

Design: Prospective noncomparative case series.

Participants: Consecutive patients seen at the Pterygium Clinic of the Singapore National Eye Centre who were thought to be unsuitable for conventional conjunctival autografting underwent a modified surgical procedure, which the authors describe as CRA. There were 51 rotation autografts performed on 45 eyes of 43 patients.

Intervention: In this procedure, the underlying fibrovascular pterygium tissue was removed and the original epithelium (with minimal subepithelial tissue included) replaced over the bare sclera with a 180 degrees rotation. Surgeries were performed by one surgeon (DT) from April 1995 to May 1996.

Main outcome measure: Pterygium recurrence and complications of CRA were measured.

Results: The mean follow-up time was 12 months (range, 2-22 months). There were 46 primary and 5 recurrent pterygia. The indications for CRA were combined cataract and pterygium surgery (39.2%), double pterygia (31.4%), the need to preserve the superior conjunctiva (21.6%), and superior conjunctival scarring (7.8%). There were two recurrences (4% recurrence rate), one occurring at 4 months and the other occurring at 7 months after surgery. No significant complications were encountered. However, 50% of the grafts remained mildly injected for more than 3 months, and some remained injected for up to 13 months after surgery (average of 4 months). Pigmentary changes were also noted in six grafts (12%).

Conclusion: Conjunctival rotation autografting is a useful technique of conjunctival grafting in cases in which it is not possible or desirable to use the superior conjunctiva as a donor source.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Transplantation
  • Conjunctiva / cytology
  • Conjunctiva / transplantation*
  • Epithelium / transplantation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pterygium / surgery*
  • Rotation
  • Safety
  • Transplantation, Autologous
  • Treatment Outcome