Conjunctival Limbal Autograft And Auto-Blood Fixation: The Modified Approach In Recurrent Pterygium Surgery

Although many surgical approaches have been developed, recurrent pterygium presents a significant surgical problem. Hunderts of study and methods have been allready described in order to prevent recurrences of pterygia.

We are describing the modified approach in recurrent pterygium surgery : 20% alcochol , conjunctival limbal autograft fixated by autologous blood.

Patient has allready had two operations on pterygia : bare sclera and conjunctival rotation.

After adequate local anesthesia the leading edge of the pterygium is dried, instilling alcohol 20% into the well and holding for 40-60 seconds. Absorbing alcohol by applicator and abundant irrigation with BSS.

Pterygium separation starting 2 mm centrally from the edges of the tissue. Excising the pterygium tissue at the base. After that a 2×2 mm area was marked centred on the superior limbus, the conjunctiva was incised, and a sub-conjunctival dissection was carried out until the limbus was reached. A shallow dissection was then carried out 1 mm into the clear cornea, and the limbal tissue was excised . The transplant is fixated with  two to three drops of  blood taken from the finger of patients and hold with two forceps for 5 minutes. Ointment tobramycin was placed in lower fornix and the eye was patched for 12 hours.

Autoblood fixation of conjunctivo limbal autograft is a new challenge for  ophthalmic surgeons and it can be considered as a standard procedure in recurrent pterygium surgery. The idea is not to apply suttures during operation, becuase they can also be initial factor for later recurrence.