recurrent pterygium. Methods: 20 cases were done in this study.pterygium was dissected from corneoconjunctival tissue and removed. A graft from superotemporal timbal conjunctival tissue was dissected and sutured At the site of dissected pterygium. Results: 90% success rate. 10% recurrence rate. Conclusion: It is a new technique used to reduce rate of recurrence after pterygium resection.
BULL. OPHTHALMOL. SOC. EGYPT, 2002; VOL. 95. NU3dBER 1, 129-133
Pterygium represent a pathological condition more frequently seen in certain population and its incidence varies greatly in different geographical zones. (I)
Pterygium has high recurrence rate after simple excsion unless any adjunctive treatment is applied. (2) The use of postoperative B radiation renders a lower incidence of recurrence but may lead to complications such as sclera' ulceration , infection or cataract (3) Mitomycin c was used locally as drops intraoperatively or postoperatively after pterygium excision to reduce rate of recurrence. It may cause serious complications as corneal odema, iritis or sclera! calcification (4) . In 1985 Kenyon and collaborates (5) introduce the conjunctival autograft for treatment of recurrent pterygium. Although this technique is more time consuming, it has reduced the number of recurrence with the same efficacy as the previously described treatment without the risk of potentialy serious complications. Some works have emphasized the importance of timbal stem cells as the cause of pterygium. They said that ptcrygium is due to hypofunction of timbal stem cells (6). Conceptually ,one could possibly reduce the number of pterygium recurrence by including the limbus in the conjunctival autograft (11 . Aim of the work
In this work we present our results of timbal conjunctival autograft in cases of advanced recurrent pterygium.
Patients and Methods
Between scptember 2001 and february 2002. timbal conjunctival autograft were performed in Bertha university hospital after pterygium resection in 20 patients with advanced recurrent pterygia. All had Previously been treated by simple excision, mitomycin c intraoperatively or B radiation postoperatively. Full oplultahnological examination was done preoperatively. The operations were done under local anaesthesia. Steps of operation were as following: l.Dissection of ptcrygium from head toward body, with removal of episcicral warring and diseased conjunctiva. A caliper was used to measure the area of conjunctiva and limbus resected with pterygium. 2. The graft was dissected from superotemporal bulbar conjunctiva. The conjunctival element measured 1 mm more in all dimensions than that of pterygium site. Saline solution was injected under the conjunctiva to separate it from tenon s capsule to facilitate its separation. Dissection began from the fornix to the limbus by the use of scissors and forceps. IThe timbal element of the graft was prepared by diamond knife.It includes 0.5 mm of peripheral comea,130u depth and with a circumferential amplitude equal to that of the limbus resected at the site of pterygium, 4.The graft was sutured by10/0 nylon sutures. Postoperatively the patients were treated with topical dcxamethasone and topranwcin drops Stds. The patients were examined postoperatively in the first, second weeks, first third and six month. Pterygium 129
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