New Technique For Conjunctivoplasty Following Pterygium Excision Using An Autologous Platelet-Rich Fibrin Membrane

To present a new regenerative approach for conjunctivoplasty following pterygium excision using an autologous platelet-rich fibrin (PRF) membrane graft. This technique aims to reduce postoperative complications—specifically recurrence and granuloma formation—by promoting rapid healing and effective tissue integration.

A pilot study was conducted at the Ophthalmology Department of HASSAN II University Hospital Center of Fez, involving 25 patients undergoing pterygium excision. All patients provided informed consent and received a PRF membrane graft during surgery. Clinical and OCT evaluations were performed on Day 1, Day 7, Month 1, and Month 3 postoperatively.

Pterygium is a common ocular surface disorder caused by abnormal fibrovascular proliferation from degenerated conjunctiva, often leading to recurrence and postoperative granuloma formation. In this study, 25 patients (mean age 58 years, male-to-female ratio of 2.5) with pterygium—24 cases nasal, 1 case with both nasal and temporal involvement, and 3 recurrent cases—underwent pterygium excision with an autologous PRF membrane graft. The surgical procedure involved obtaining a venous blood sample in dry tubes, immediately centrifuging it at 3500 rpm for 15 minutes to yield three layers. The intermediate layer, a fibrin clot, was used to create a fresh, autologous PRF membrane, which was then grafted onto the scleral bed. The average operative time was 15 minutes. Postoperatively, all patients experienced reduced photophobia, with early signs of healing observed by Day 1, including corneal ulcer resolution and stable membrane fixation. The PRF membrane was fully resorbed and integrated within 5 to 10 days (mean 7 days), and conjunctival migration was noted at approximately one month, with OCT revealing a hyporeflective band continuous with the corneal epithelium. No recurrences or granuloma formations were observed at the 4-month follow-up, and preoperative and postoperative visual acuities remained unchanged.

The use of an autologous PRF membrane in pterygium surgery is a simple, effective, and promising technique that offers low recurrence and complication rates while promoting rapid healing. However, longer-term clinical studies are needed to confirm the reliability and durability of these results.