Outcomes And Effectiveness Of Conjunctival Rotation Autograft In Primary Nasal Pterygium Surgery

To evaluate postoperative outcomes and effectiveness of conjunctival rotation autograft technique in primary pterygium surgery. The outcomes and effectiveness were evaluated by the percentage of intra and postoperative complications and recurrence.

In this prospective pilot study, 26 eyes of 23 patients were operated and evaluated postoperatively in Department of Ophthalmology of University Hospital Centre Zagreb from September 2024. to September 2025. Of the 23 patients, 16 (70%) were males. The mean age of the patients was 65 years, with a range of 47 to 81 years. All patients had primary nasal pterygium. Follow-up time was at least twelve months.

Inclusion criteria were patients older than 18 years and primary nasal pterygium. A non-inclusion criterion was patients with recurrent pterygium. Informed consent was obtained from all patients before surgery. The best-corrected Snellen visual acuity, intraocular pressure, and details of slit-lamp and fundus examinations were recorded prior to surgery. Patients were followed at one week and one, two, six and twelve months. Follow-up examinations consisted of best-corrected Snellen visual acuity and slit lamp examination. The complications were defined as intra or post-operative incidents requiring further treatment. We defined clinically significant recurrence as pterygial regrowth that required a surgical procedure to remove.

During the first couple weeks, all patients reported redness and mild irritation. In all patients, cornea reepithelialized during the first week after surgery. There were no intra- or post-operative complications requiring further treatment. At an end follow-up of twelve months, no recurrence was noted. On slit lamp examinations, we founded graft injection in 10 (26%) eyes up to six months, but there were no complaints from patients regarding that.

Conjunctival rotation autografting was first described as an alternative to conventional conjunctival autograft after pterygium excision in cases in which it is not possible or desirable to use the superior conjunctiva as a donor source. We reported our experience with conjunctival rotation autografting technique and evaluated the postoperative outcomes in primary pterygia patients and concluded that it appears to be an effective and safe technique in management of primary nasal pterygium. A limitation of our study is its noncomparative design and relatively low number of participants. Further randomized controlled trials to compare conjunctival rotation autografting with different methods are necessary.