A modified technique for conjunctival transplant.

An improved technique for the harvesting and placement of conjunctival autograft in complex, advanced and recurrent pterygia is presented. A paper template, fashioned to the approximate size of the pterygium excision site, is used to mark and subsequently transfer the conjunctival graft to the recipient bed. The template creates a strong, steady scaffold on which to orient and align the floppy conjunctival graft. This permits easier suturing and more accurate placement of the graft. We report a series of 30 eyes in which all transplants were taken from the superior or superotemporal bulbar conjunctiva of the same eye. There were no intraoperative or postoperative complications. No graft failures or graft retractions were seen. Although there have been several cases of partial recurrence, we have not had to resort to repeat surgery. We present this modification of a technique originally developed by Thoft and later refined by Vastine and Kenyon, as an effective way to correct complex, advanced, and recurrent pterygia.