A recurring fleshy, triangular, vascularised growth on the nasal conjunctiva extending 2 mm onto the cornea is present in a 50-year-old outdoor worker. He asks about treatment. The preferred surgical technique to minimise recurrence is:
- A Simple excision of the pterygium down to bare sclera
- B Excision with adjunctive intraoperative mitomycin-C application
- C Excision followed by conjunctival autograft from the superior bulbar conjunctiva ✓
- D Beta-irradiation postoperatively to prevent recurrence
Explanation
Pterygium is a wing-shaped fibrovascular growth from the nasal (or temporal) conjunctiva onto the cornea, associated with UV exposure. The bare sclera technique has a very high recurrence rate (30–80%). Conjunctival autografting (transplanting a free graft from the superotemporal bulbar conjunctiva to cover the bare sclera after excision) has the lowest recurrence rate (< 5–10%) by covering the sclera with healthy limbal tissue and providing a barrier to fibrovascular ingrowth. Intraoperative or postoperative MMC is used as adjuvant but carries risk of scleral melting and calcification with repeated use.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.