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New Surgical Technique for Pterygium:Conjunctival In situ Autograft

Background: Pterygium is mainly due to dysfunction of limbal stem cells with a proliferative and locally invasive front. Conjunctiva overlying body (pterygial conjunctiva) has fairly normal epithelium; hence this can be used as auto graft. Aim of the study is to analyse surgical and morphological outcome of new auto graft technique to treat pterygium, termed as Conjunctival in situ auto graft: CISAG.

Methods: Include dissection of Pterygial conjunctiva from 1mm inside limbus, rest of the neck and apex were torn like rrhexis. Remaining fibrotic tissues were meticulously dissected from conjunctiva and sclera. Curuncular end of the graft was placed along limbus over bare sclera. Fibrin secreted from clotted blood helped to keep graft in place. Weekly follow up was done for 1 month and then monthly for a year. Apical pterygial conjunctiva was sent for HPE. Results included total 10 cases of primary pterygium, 2 recurrent pterygium and 2 cases of combined cataract and pterygium. No recurrence was observed during the follow-up period.

Conclusion: This procedure requires no suture, no glue. No extra conjunctiva other than the affected is traumatized during surgery. Our results were similar to other auto graft techniques but this new technique named CISAG saves time, tissue and recurrence.


Sanjoy Chowdhury, Sneha and Priti

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