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Indian J Ophthalmol. 2020 Apr;68(4):573-576. doi: 10.4103/ijo.IJO_1079_19.

Comparison of vertical split conjunctival autograft with and without limbus to limbus orientation in cases of double-head pterygium-A retrospective analysis.

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Department of Cornea and Refractive Services, The Eye Foundation, Coimbatore, Tamil Nadu, India.



The aim of this study is to compare the outcome and complications in patients who underwent double-head pterygium excision with split conjunctival autograft with and without limbus to limbus orientation.


In this retrospective, comparative study, 99 eyes with double-head pterygium which underwent split conjunctival autograft with limbus to limbus orientation (Group 1) and 93 eyes which underwent without limbus to limbus orientation (Group 2) during the period of 2011-2016 were included in this study. The primary outcome compared was the recurrence rate. Other complications were included as secondary outcomes.


Mean age in group 1 and group 2 were 46.84 +/- 10.78 years and 54.38 +/- 11.44 years respectively. M:F was 36:63 in group 1 and 45:48 in group 2 with a mean follow up of 18.30 +/- 7.48 months in group 1 and 17.04 +/- 9.98 months in group 2. Recurrence was seen in 4 cases in each of the 2 groups with the mean time of recurrence being 7 +/- 2.34 months in group 1 and 6 +/- 2.01 months in group 2. Other complications included graft edema, SCH, graft retraction, granuloma, dellen and graft loss with only graft loss being statistically significant between 2 groups.


This study provides data that recurrence rates are not different among patients who undergo split conjunctival graft with and without limbal orientation. The strict adherence to maintaining limbus to limbus orientation while managing double-headed pterygia may not be necessary in all cases, especially in those with large defects following excision.


Double-head pterygium; limbal orientation; recurrence; split conjunctival autograft

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