Clinical outcome study of a modified surgical technique for pterygium excision

BACKGROUND: Pterygium is a common condition that has many and varied surgical management techniques. Our aim was to describe and evaluate the safety and efficacy of a modified tissue-sparing surgical procedure for management of pterygium. METHODS: This was a retrospective, clinical outcome study of 67 consecutive pterygium head excisions and mini inferior conjunctival autografts (PHEMICA), performed by a single senior surgeon over 7 years. The technique evaluated was a modified pterygium head removal and inferior conjunctival autograft, maximising host tissue preservation. RESULTS: Group A (primary pterygia): 5.25% recurrence rate (3 of 57 eyes). Group B (recurrent pterygia): 30% recurrence rate (3 of 10 eyes). No major complications occurred. One partial autograft necrosis was noted (1.5%, 1 of 67 eyes), with full resolution. INTERPRETATION: The described technique is fast, safe, and effective with a 5.25% recurrence rate in those with primary pterygia. It is not, however, recommended in the treatment of recurrent pterygia; this group of patients requires a more radical excision with a larger autograft and the use of adjuncts such as mitomycin C.