Pterygium Surgery Using Anchored Conjunctival Rotation Flap Vs Conjunctival Autograft – A Comparative Study

Abstract

Background: Pterygium is a common ocular surface disorder characterized by fibrovascular proliferation of conjunctival tissue onto the cornea, often resulting in irritation, cosmetic concerns, induced astigmatism, and visual impairment. Conjunctival autograft is widely regarded as the standard surgical treatment; however, anchored conjunctival rotation flap surgery has emerged as an alternative technique with potential advantages in surgical efficiency and graft stability. This study compared the efficacy, safety, and postoperative outcomes of anchored conjunctival rotation flap and conjunctival autograft techniques in the management of primary pterygium.

Methods: A hospital-based analytical comparative study was conducted at the Department of Ophthalmology, Jawaharlal Nehru Medical College, Ajmer, from June 2024 to May 2025. Eighty patients with primary pterygium were enrolled and equally divided into two groups: conjunctival autograft (Group A, n=40) and anchored conjunctival rotation flap (Group B, n=40). Demographic characteristics, surgical duration, postoperative astigmatism, complications, and recurrence rates were evaluated during follow-up visits up to one year. Statistical analysis was performed using SPSS version 26.0, with p<0.05 considered statistically significant.

Results:  Baseline demographic and clinical characteristics were comparable between the groups. Mean surgical duration was significantly shorter in the rotation flap group (27.4±5.4 minutes) compared with the autograft group (30.25±5.3 minutes) (p=0.020). Both groups demonstrated significant reduction in postoperative astigmatism, with a significant intergroup difference observed at three months (p=0.026). Recurrence occurred in 5.0% of patients in the autograft group and 8.1% in the rotation flap group. Postoperative complications were mild and self-limiting in both groups.

Conclusion: Both conjunctival autograft and anchored conjunctival rotation flap techniques are safe and effective for primary pterygium surgery. The anchored conjunctival rotation flap technique offers shorter operative time with comparable clinical outcomes, making it a reliable alternative to conjunctival autografting.