Abstract : Purpose: To evaluate the post-operative outcome of double headed pterygium excision followed by
superior and inferior sutureless conjunctival autografts
Materials and Methods: A retrospective study of the patients operated for double headed pterygium
was done between 1st June 2018 and 30th June 2019 at a tertiary care hospital of southern Rajasthan.
A detailed history was taken including age, sex, occupation, duration of pterygium, history of chemical
injuries, medical and surgical history. Unaided visual acuity was noted with a Snellen’s distant vision
chart. Depending on the extent of corneal involvement the pterygium was graded as follows: Grade Icrossing
the limbus, Grade II-midway between the limbus and pupil, and Grade III-crossing the pupillary
margin. Routine blood investigations along with bleeding time (BT) and clotting time (CT) were accessed.
All the surgeries were done by a single surgeon. A superior and an inferior conjunctival autografts were
Results: A total of 14 patients with primary double headed pterygium were operated by a single surgeon
using the above mentioned technique. Retrospective analysis was done. 13(92.86%) patients were affected
unilaterally and 1(7.14%) patient had bilateral double headed pterygium. 11(78.5%) out of 14 were male
and 3(21.5%) were female. Mean age of patients was 46.5 15.5 years. Out of 15 nasal pterygia, 2(13.3%)
were grade-I, 9(60%) were grade-II and 4(26.6%) were grade-III. Out of 15 temporal pterygia, 6(40%)
were grade-I, 6(40%) were grade-II and 3(20%) were grade-III. Mean follow-up was 12+6 months. No
significant intra-operative complications were noted. Post-operative vision improvement was recorded at 3
month follow-up with a Snellen’s distant vision chart. An average of 3+2 Snellen’s lines improvement
was noted in unaided vision. Most common post-operative complication was graft oedema in 9 grafts out
of 30 (30%). Graft retraction was found in 2 grafts (6.66%).Sub-conjunctival haematoma was found in 1
graft (3.3%). Graft loss was found in 1 graft.
Keywords: Double headed pterygium, Inferior conjunctival autograft, Pterygium surgery.