Evaluation of the Effectiveness of Rotational Conjunctival Flap Compared to Free Autografting for Ocular Surface Reconstruction after Surgical Removal of Primary Pterygium

Background: pterygium is a fibrovasular lesion of the ocular surface that can display an aggressive clinical behavior and occasionally, threatens the vision. Although there is no consensus on its pathogenesis, recent evidence suggests that is a prolifrative rather than degenerative condition, strongly correlated with exposure to ultraviolet radiation of solar light. Objictive: the purpose of this study was to compare the surgical outcomes when using the technique of conjunctival autograft versus conjunctival rotational flap for reconstruction of ocular surface following primary pterygium excision. Patients and Methds: this study included 20 eyes of 20 patients with primary pterygia attending at the National Eye Center, Rod El Afarag Hospital. Operated eyes were divided into 2 groups, 10 eyes each Group A: included 10 eyes managed by pterygium excision followed by ocular surface reconstruction using rotational conjunctival flap technique. Group B: included 10 eyes managed by pterygium excision followed by ocular surface reconstruction using free conjunctival autograft technique. Results: The better result wase in cases treated by conjunctival autograft group with 10 % recuurence while the higher recurrence rate 20% was seen in cases by rotational conjunctival flap group. Other minor complications were found such as flap retraction in 2 cases of group, buttonhole of the graft in one case in group B, flap edema was in lower incidence than graft edema and no suture granuloma happened in both groups. Conclusion: free conjunctival autograft and rotational conjuctiavl flap showed comparable results, in reducing recuurence rate; they are safe and effective methods of pterygium surgery that produces only few complications.