• Muhammad Naqaish Sadiq
  • Abdus Salam Arif
  • Sulman Jaffar
  • Jagdish Bhatia


Background: A pterygium is a fibro-vascular, wing shaped encroachment of the conjunctiva on to thecornea. The prevalence rates ranges from 0.7 to 31% among different populations and also influencedby age, race, and exposure to solar radiations. Ultraviolet light-induced damage to the limbal stem cellbarrier with subsequent conjunctivalisation of the cornea is the currently accepted aetiology of thiscondition. Indication of surgery include visual impairment, cosmetic disfigurement, motility restriction,recurrent inflammation and interference with contact lens wear. This Study was conducted to know thesafety, efficacy and success with supero-temporal free conjunctivo-limbal auto graft transplantation inthe surgical management of pterygium. Methods: Prospective case series where supero temporal freeconjunctivo-limbal auto grafting was performed on 72 eyes of 72 patients with vascular progressivepterygia. Pterygium recurrence was considered a surgical failure. Recurrence was defined as fibrovascular tissue crossing the corneo-scleral limbus on to the clear cornea in the area of previouspterygium excision before 6 months. Results: Recurrence of pterygium was noted in three out of 72eyes (4.16%), after a minimum follow up of 12 months to maximum of 25 months (Mean 14.6months). No major intra-operative or postoperative complications were encountered. Conclusion:Supero temporal free conjunctivo-limbal auto graft appears to be a safe and effective technique in thesurgical management of pterygium. The inclusion of limbal tissue in the conjunctival auto graftfollowing pterygium excision appears to be essential to ensure low recurrence rate.Keywords: Conjunctival auto graft, limbal transplantation, pterygium, recurrence


Dushku N, Reid TW. Immunohistochemical evidence that

human pterygia originate from an invasion of vimentin–

expressing altered limbal epithelial basal cells. Curr Eye Res


Sebban A, Hirst LW, Kynaston B, Bain C. Pterygium

recurrence rate at the princess Alexandra Hospital, Aust NZ J

Ophthalmol 1991;19:203–6.

Singh G, Wilson MR, Foster CS. Long term follow up study

of mitomycin eye drops as adjunctive treatment of pterygia

and its comparison with conjunctival autograft

transplantation. Cornea 1990;9:331–4.

Frucht-Pery J, Ilsar M, Hewmo I. Single dose of mitomycin –

C for prevention of recurrent pterygium: Preliminary report.

Cornea 1994;13:411–3.

Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival

autograft transplantation for advanced and recurrent

pterygium. Ophthalmology 1985;92:1461–70.

Rubinfeld RS, Pfister RR, Stein RM, Foster Cs, Martin NF,

Stoleru S, et al. Serious complications of topical mitomycinC after pterygium surgery. Ophthalmology 1992;99:1647–54.

Hayasaka S, Noda S, Yamamoto Y, Setogawa T.

Postoperative instillation of low dose mitomycin-C in the

treatment of primary pterygium. Am J Ophthalmol


Helal M, Messiha N, Amayem A, El-maghjaby A, El Sherif,

Dabees M. Intraoperative mitomycin-C versus postoperative

topical mitomycin-C drops for the treatment of pterygium.

Ophthalmic Surg Lasers 1996;27:674–8.

Yamanouchi U, Takaku I, Tsuda N, Kajiwara Y, Mine M,

Ueno Y. Scleromalacia presumably due to mitomycin-C

instillation after pterygium excision.Jpn J Clin Ophthalmol


Chen PP,Ariyasu RG, Kaza V,Labree LD, Mc Donnell PJ. A

randomized trial comparing mitomycin –C and conjunctival

autograft after excision of primary pterygium. Am J

Ophthalmol 1995;120:151–60.

Lewallen SA. Randomized trial of conjunctival autografting for

pterygium in the tropics. Ophthalmology 1989;96:1612–4.

Koch JM, Mellin JB, Wauble TN. The pterygiumAutologous conjunctiva-limbus transplantation as treatment.

Ophthalmology 1992;89:143–6.

Guler M, Sobaci G, Liker S, Ozturk F, Muthi FM, Yildirim

E. Conjunctival autograft transplantation in cases with

recurrent pterygium. Acta Ophthalmol 1994;72:721–6.

Shimazaki J, Yang HY, Tsubota K. Limbal autograft

transplantation for recurrent and advanced pterygia.

Ophthalmic Surg Lasers 1996;27:917–23.

Rao SK, Lekha T, Mukesh BN, Sitalakshmi G, Padmanabhan

P. Conjunctival-limbal autograft for primary and recurrent

pterygia: Technique and results. Indian J Ophthalmol


Pulte P, Heiligenhaus A, Koch J. Long term results of

autologous conjunctiva-limbus transplantation in pterygium.

Klin Monatsbl Augenheilkd 1998;213:9–14.

Mutlu FM, Sobaci G,Tatar T, Yildirim E. A comparative

study of recurrent pterygium surgery: Limbal conjunctival

autograft transplantation versus mitomycin-C with

conjunctival flap. Ophthalmology 1999;106:817–21.

Figueiredo RS, Cohen EJ, Gomes JAP, Rapuano CJ, Laibson

PR. Conjunctival autograph for pterygium surgery: how well

does it prevent recurrences? Ophthalmic Surg Lasers


Tseng SCG, Chen JJY, Huang AJW, Kruse FE, Maskin SL,

Tsai RJF. Classification of conjunctival surgeries for corneal

diseases based on stem cell concept. Ophthalmol Clin North

Am 1990;3:595–610.

Vtabec MP, Weisenthal RW, Elsing SH. Subconjunctival

fibrosis after conjunctival auto grafts. Cornea 1993;12:181–3.



Most read articles by the same author(s)