Comparison of Conjunctival Transposition Flap Versus Conjunctival Autograft in Pterygium Recurrence

Abstract

Purpose: To compare outcomes of conjunctival transposition flap versus conjunctival autograft techniques in terms of recurrence following primary pterygium excision.

Methodology: This randomized controlled trial was conducted at the Department of Ophthalmology, Bakhtawar Amin Medical and Dental College, Multan from June 2023 to June 2024. A total of 144 patients with primary pterygium were enrolled and randomly assigned to undergo either conjunctival transposition flap (Group A) or conjunctival autograft (Group B). Surgeries were performed by a single experienced ophthalmologist. Patients were followed postoperatively at one, three, and six months to assess recurrence and complications.

Results: The mean age was 50.9 ± 10.5 years; 52.8% were male. The recurrence rate was 8.3% overall, with Group A showing 11.1% and Group B 5.6% (p = 0.367). A significantly lower mean operative time was observed in Group A (17.2 ± 1.0 minutes) compared to Group B (25.4 ± 1.0 minutes) (p < 0.001). Graft edema and dellen formation were slightly more frequent in Group B but did not reach statistical significance.

Conclusion: Both techniques had comparable recurrence and complication rates. However, the transposition flap technique offered the advantage of significantly reduced surgical time, making it a viable alternative in routine surgical practice.

Keywords: Pterygium, Conjunctival Autograft, Transposition Flap, Recurrence, Randomized Controlled Trial