Sanjukta Mahapatro, Rajendra Kumar Behera, Suchitra Dash, B. Nageswar Rao Subudhi
BACKGROUND A large section of the society is pursuing occupations in the outdoors which exposes the eyes to the ultraviolet radiations. The UV exposure leads to primary pterygium which in turn may lead to loss of vision. Persons with sedentary occupations in the indoors also have reported with primary pterygium although they are less in number. Prognosis of surgical treatment is encouraging. Therefore, the authors are motivated to incorporate two safer methods of surgeries. They are Conjunctival autograft and Conjunctival rotation flap techniques in primary pterygium surgery. The objectives of this study were to evaluate the complications and recurrence rate after primary pterygium excision with conjunctival autograft and conjunctival rotation flap techniques over a span of 18 months and to compare the two aforesaid methods as they are safer techniques in the treatment of primary pterygium. MATERIALS AND METHODS It is a prospective study conducted at P. G. Department of Ophthalmology, MKCG Medical College and Hospital, Berhampur from April 2016 to Sep 2017 (18 months). 40 patients were operated upon. Following primary pterygium excision, autoconjunctival graft was employed in 21 cases and conjunctival rotation flap was utilised in 19 cases. 36 patients were in the age group 32 to 60 years and 4 patients were more than 60 years old. RESULTS High prevalence of pterygium was seen in age group of 40 to 49 years (18 eyes - 45%). There is high incidence (80%) of pterygium in patients who have their occupation in outdoors which exposes persons to ultraviolet radiations. Patients of pterygium were less in number (20%) who have indoor occupations. All the pterygium were nasally located with mean corneal encroachment of 3mm X 3mm. 55% of surgeries were carried out on the right eyes and 45% of surgeries were carried out on left eyes. During the follow up period of this study, progressive pterygium recurred in 2 patients. The average duration of recurrence was 5.5 months. The mean age of patients with recurrence was 46 years. Mean surgical time spans in conjunctival rotation flap and conjunctival autograft group were 18 minutes and 25 minutes respectively. The recurrence in conjunctival autograft and conjunctival rotation flap groups were 4.76% and 5.26% respectively. CONCLUSION Both conjunctival rotation flap and conjunctival autograft techniques have almost same results in terms of pterygium recurrence and surgical complications in the treatment of primary pterygium, surgical time span in conjunctival rotation flap technique is significantly shorter. So, the conjunctival rotation flap technique may be a good alternative method for primary pterygium surgery.
