Evaluation of the Use of Intraoperative Subconjunctival Injection of Triamcinolone Acetonide and Limited Peritomy during Bare Scleral Pterygium Excision

Aims: To evaluate the efficacy and safety of subconjunctival injection of triamcinolone acetonide (TA) and limited peritomy during bare scleral pterygium excision in preventing pterygium recurrence.

Study Design: A prospective non-randomized interventional case series.

Place and Duration of Study: All surgeries were done at the department of ophthalmology of Assiut university hospital (27 eyes) and Alforsan eye center in Assiut (3 eyes), Egypt, between November 2017 to December 2019.

Methodology: Thirty eyes of 26 patients who underwent pterygium excision with bare sclera combined with intraoperative subconjunctival TA injection and limited peritomy primary pterygium grade 2 (T2, 3 eyes) and grade 3 (T3, 30 eyes). All patients were followed up for 12 months after surgery. Pterygium recurrence and complications were the key outcome steps.

Results: Pterygium recurrence was seen in 3 eyes (10.0%) as following: grade 2 in one eye (3.3%) and grade 3 in two eyes (6.7%). Intraocular pressure elevation was observed in 9 eyes (30%). The IOP rise ranged from (22.4 to 37 mmHg). All eyes were successfully treated medically and reached normal values by the end of postoperative sixth month.

Conclusion: This procedure appears to be reasonably safe and successful in reducing pterygium recurrence.