Conjunctival Granulomas More Common than Recurrence in an 11-year Series of Pterygium Surgery.

Objectives: To present an 11-year case series of pterygia.

Methods: We conducted a retrospective case review of all pterygium surgeries performed at Dartmouth Hitchcock Medical Center between April 2011 and July 2022. Eighty-six cases were identified through a chart review identifying procedures with the code «Excision of Pterygium W/Transplant» on our electronic medical record system, obtained per a protocol approved by the Dartmouth-Hitchcock Health Human Research Protection Program (IRB study 02002030).

Results: Of 86 cases, 84 were performed with conjunctival autografting (CAG) with fibrin glue, one was performed with just amniotic membrane transplant (AMT) with fibrin glue, and one was performed with both CAG and AMT with fibrin glue. No intraoperative mitomycin C or 5FU were used. Three patients with postoperative complications were identified, including two cases of postoperative conjunctival granulomas and one case of recurrent pterygium. Both conjunctival granulomas were treated with surgical excision without recurrence and sent to pathology for analysis. Histopathological findings are discussed herein. The recurrent pterygium was treated with 5FU injections, after which there were minimal symptoms and no progression at the last follow-up.

Conclusions: Although recurrence is the most commonly discussed complication of pterygium surgery, in our cases, over an 11-year span, we found that postoperative conjunctival granulomas were more common than recurrence.