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The Manihala maneuver: pterygium conjunctiva autograft's adieu to second site harvest

Poster Details

First Author: J.Sandhu INDIA

Co Author(s):                  

Abstract Details


To report the outcomes and safety of single site surgery using pterygium conjunctiva autograft.


Prospective case series of 83 consecutive surgeries for primary pterygium performed at rural eye hospital


The pterygium conjunctiva was dissected from the underlying fibro vascular component which was excised at the base. The thin clear free autograft was applied on bare sclera after 90° rotation and without sutures or glue


Mean follow-up 14.4 ± 3.2 months, assessing complications, recurrence and aesthetics. There was graft dislodgement in 3 eyes (3.6%), granuloma formation in 3 eyes (3.6%), graft edema in 2 eyes (2.4%), recurrence in 1 eye (1.2%). 74 patients (89.1%) expressed satisfaction with cosmesis. Despite histological modifications due to exposure and inflammation, the pterygium conjunctiva autograft forms a physical barrier of conjunctival tissue adjacent to the limbus, preventing recurrence and delivering surgical success results comparable to free superior conjunctiva autograft. The surgical success is also dependent on the thinness of graft material obtained after fine dissection.


This single site technique can be useful in preserving extralesional conjunctiva. This technique promises advantage of foregoing second site intervention and preservation of a healthy superior conjunctiva for needs of possible filtration surgery or conjunctival autograft requirement in future. FINANCIAL INTEREST: NONE

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