International journal of ophthalmology · 2026
Pentagonal vs quadrangular conjunctival autograft in pterygium surgery: a comparative study on graft retraction.
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Bahar Alperen, Doğan Aysun Şanal
Аннотация
AIM: To investigate the effect of pentagonal conjunctival autograft on reducing graft retraction following pterygium surgery.
METHODS: This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal (created by shaping the junction with the recipient conjunctiva into a wedge) or quadrangular conjunctival autograft transplantation. All patients completed a 6mo postoperative follow-up. The primary outcome measure was the incidence of graft retraction; secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.
RESULTS: The study enrolled 58 participants, comprising 26 (15 males, 11 females) in the pentagonal graft group (mean age: 54.9±13.1y), and 32 (17 males, 15 females) in the quadrangular graft group (mean age: 57.6±10.4y). Graft retraction occurred in only 1 eye (3.8%) in the pentagonal autograft group, compared to 9 eyes (28.1%) in the quadrangular autograft group. No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group. Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft, the difference was not statistically significant (P>0.05).
CONCLUSION: Designing the conjunctival autograft in a pentagonal shape-mimicking geodesic dome architecture and conforming to the eye's spherical structure-enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces. This design effectively reduces the incidence of graft retraction and other related complications, providing a more favorable surgical option for pterygium treatment.
METHODS: This retrospective comparative study included patients who underwent primary pterygium excision with either pentagonal (created by shaping the junction with the recipient conjunctiva into a wedge) or quadrangular conjunctival autograft transplantation. All patients completed a 6mo postoperative follow-up. The primary outcome measure was the incidence of graft retraction; secondary outcomes included graft displacement requiring re-suturing and pterygium recurrence rate.
RESULTS: The study enrolled 58 participants, comprising 26 (15 males, 11 females) in the pentagonal graft group (mean age: 54.9±13.1y), and 32 (17 males, 15 females) in the quadrangular graft group (mean age: 57.6±10.4y). Graft retraction occurred in only 1 eye (3.8%) in the pentagonal autograft group, compared to 9 eyes (28.1%) in the quadrangular autograft group. No cases of graft displacement requiring re-suturing were reported in the pentagonal autograft group. Although graft displacement and recurrence requiring re-suturing were observed less frequently in surgeries with a pentagonal graft, the difference was not statistically significant (P>0.05).
CONCLUSION: Designing the conjunctival autograft in a pentagonal shape-mimicking geodesic dome architecture and conforming to the eye's spherical structure-enhances compatibility with the recipient conjunctiva and improves resistance to physical traction forces. This design effectively reduces the incidence of graft retraction and other related complications, providing a more favorable surgical option for pterygium treatment.