THE SURGICAL-MANAGEMENT OF AN ADVANCED PTERYGIUM INVOLVING THE ENTIRECORNEA

Purpose, Conjunctival autografting is a well-established surgical proc edure to prevent recurrence after pterygium excision. We described a m odified technique of harvesting an annular autograft to cover a large conjunctival defect after excision of an extensive primary pterygium t hat involved three quadrants of the limbus. Methods, A 73-year-old Chi nese farmer underwent an excision of an advanced right pterygium invol ving the entire cornea. A free donor graft was then harvested from the remaining superior bulbar conjunctiva to cover the conjunctival defec t, which involved approximately three quadrants of limbus. The undersi zed graft was split down the center to create an annular graft to cove r the defect. Results, Postoperatively, there has been no recurrence o ver a total follow-up period of 11 months. Six months after the initia l pterygium surgery, he underwent a successful penetrating keratoplast y for residual deep stromal scarring. Visual acuity 5 months after the penetrating keratoplasty remained stable at 6/18. Conclusions. This c ase report shows that a modified technique of conjunctival autograftin g can be successful in preventing recurrence in an advanced pterygium after excision. Successful visual rehabilitation with a penetrating ke ratoplasty also was demonstrated in this patient.