Abstract:
Introduction. Recurrent pterygium is clinically manifested by a triangular fold of the bulbar
conjunctiva with the base towards the semilunar fold and the tip towards the cornea. The etiology
and pathogenesis of recurrent pterygium is unknown. It would result from a corneo-conjunctival
epithelial alteration, associated with a proliferation of fibrinogen tissue, progressing between the
epithelium reduced to a few layers of cells and the perforated Bowman's membrane.
Aim. To assess the effectiveness of a modified method in the treatment of recurrent pterygium.
Objectives:
1. To determine the effectiveness of the modified method using the free conjunctival flap in the
treatment of recurrent pterygium.
2. To appreciate the benefits of the modified method depending on the addressability of patients
with recurrent pterygium.
Materials and methods. The study included 10 patients (5 men and 5 women) with recurrent
pterygium aged 20-71 years who underwent pterygium removal according to a modified method.
Thus, during the surgical intervention, a movable, free, rectangular flap with sides 5 x 3 mm was
prepared inferiorly paralimbally, which was fixed conjunctivally paralimbally, nasally in the area of
the body of the pterygium translocated to the superior or inferior fornix. It is important to position
the formed conjunctival flap with a limbal orientation.
Discussions. The postoperative recovery was fast, but for several days after the operation the globe
was hyperemic, irritating the suture fibers used to fix the conjunctival autograft. Antibiotic and antiinflammatory in the form of eye drops are needed. Thus, in all patients, 3 months after the
microsurgical intervention, no signs of recurrence of the operated pterygium were detected. In 2
late-presenting patients, the pterygium was extended onto the cornea, resulting in deep scarring. As
a consequence, the radius of corneal curvature was changed with the decrease in visual acuity in the
postoperative period. This is why surgery for recurrent pterygium should not have been delayed.
Conclusions:
1. The microsurgical method proposed for the treatment of recurrent pterygium is safe and
effective, determining the lack of recurrence in the postoperative period.
2. Microsurgical intervention based on recurrent pterygium should be performed as early as
possible.
