Abstract
Purpose :
To report the incidence of ptosis following harvesting of conjunctival autografts during the repair of primary and recurrent pterygia with and without a superior limbal traction suture.
Methods :
All surgeries were performed by the same surgeon (AZS). History of prior pterygium removal in the operated eye was noted. Margin reflex distance 1 (MRD1), defined as the distance between the center of the upper lid margin to the the pupillary light reflex, was noted pre-operatively and 3 months post-operatively. Post-operative complications including pterygium recurrence, pyogenic granuloma, graft detachment and steroid induced ocular hypertension were recorded.
Results :
50 consecutive eyes of 50 patients were included in the study. 40 (80%) cases were primary and 10 (20%) were recurrent. Patients were comprised of 30 males (60%) and 20 (40%) females. The cohort was distributed equally among 2 groups: Group A where the surgery was performed with a superior limbal traction suture to improve visualization of the superior bulbar conjunctive during graft harvesting and group B where no traction suture was used. Each group contained 20 primary cases/ 5 recurrent cases. Two patients in group A (8%) and 3 in group B (12%) had significant ptosis 3 months postoperatively (defined as a reduced MRD1 by 2 or more mm from baseline) (p<0.3). One patient had a pyogenic granuloma that resolved with topical treatment. Two patients had steroid induced ocular hypertension that was controlled with topical therapy. No recurrences or graft detachments occurred in any of the patients at the 3 month follow up visit.
Conclusions :
Postoperative ptosis is not an uncommon finding after pterygium surgery with conjunctival autograft. Using a limbal traction suture did not seem to lower the incidence of this complication.
This is a 2020 ARVO Annual Meeting abstract.