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I. Ezon, C. Y. Shih, I. J. Udell; Outcomes of Double Headed Pterygium Excision. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2398.
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To evaluate the post-surgical outcome of double headed pterygium excision.
Retrospective case series of 5 eyes with double headed pterygia that underwent primary surgical removal. Procedures involved surgical excision with a conjunctival autograft placement in the place of one head and amniotic membrane in the place of the second head, except for one case with insufficient viable conjunctiva to harvest where amniotic membrane replace both heads. Tisseel adhesive and varied sutures were used for securing closures (see Table 1). One patient underwent concurrent lamellar keratectomy for Salzmann’s nodules.
Five eyes, from 5 patients, were identified as having surgical intervention for double headed pterygium from January 2003 through October 2009. Characteristics are listed in Table-1. Average follow-up was 48 weeks (range 14-120weeks). Average pterygium size pre-op was 3.0mm +/- 1.5mm. Postoperatively, two patients had both heads recur, and one patient had the temporal head recur. Recurring pterygia averaged a pre-op size of 3.4mm +/- 2.0mm, whereas non-recurring pterygia averaged 2.6mm +/- 0.7mm. No pterygium recurrence required repeat surgery during the follow-up period. Recurrence rate was the same for autograft and amniotic membrane closures (50%). Intraocular pressure elevation was recorded in 4 patients but all were transient and modest, resolving within 6 months with prednisolone acetate taper and use of short-term glaucoma drops in 3 patients.
Recurrence of pterygium after surgical excision may be higher for patients who have double headed pterygia as compared to those who have unilateral pterygium. The incidence of recurrence was equal for both conjunctival autograft and amniotic membrane graft use.
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