Comparison of Recurrence Rate and Outcomes of Pterygium Surgery with Inferior Versus Superior Rotational Conjunctival Flap: A Randomized Clinical Trial
In brief
Inferior and superior pterygium flaps each had two recurrences in a trial
In this randomized trial of 82 patients with primary pterygium, two patients in each flap group had recurrence during six months of follow-up. Visual acuity, inflammation, healing, and complications also showed no detected differences. The small, single-center study supports inferior flaps as an option when the upper conjunctiva is unavailable, but larger trials are needed to confirm the findings.
- Journal
- Journal of ophthalmic & vision research (Q2)
- Published
- 21 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Hassan Behboudi, Mitra Akbari, Reza Soltani Moghadam, Hamed Molaei, Ehsan Kazemnezhad Leili
- PMID
- 42780609
- DOI
- 10.18502/jovr.v21.17916
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 27 September 2026): RCT comparing inferior vs superior rotational conjunctival flap
Abstract
PURPOSE: Limited knowledge exists about the recurrence and complications of rotational flaps harvested from the inferior bulbar conjunctiva in pterygium surgery. This study aimed to investigate the outcomes and recurrence rate of pterygium surgery using inferior rotational conjunctival flap (IRCF) compared with superior rotational conjunctival flap (SRCF) surgery. METHODS: This randomized clinical trial was performed on 82 candidates for pterygium surgery (primary pterygium with horizontal extension > 3 mm). The patients had been admitted to Amiralmomenin Hospital (Rasht, Iran) in 2023-2024 and were randomized to "group A" (IRCF surgery) and "group B" (SRCF surgery) using a single-blind method. They were visited on days 1, 3, 7, 30, 90, and 180 post-surgery, and their best corrected visual acuity (BCVA), clinical inflammation, complications, and recurrence were recorded and compared using SPSS version 26. RESULTS: Recurrence was observed in two patients in each group: in group A, one case in the third month and another in the sixth month post-surgery; and in group B, two cases in the third month post-surgery. Frequency of corneal epithelial defect healing, frequency of complications, inflammation severity, BCVA, and recurrence rate did not differ between the two groups at any follow-up visits (P > 0.05). There was no statistically significant difference between the two groups in terms of recurrence rates, categorized by pterygium size and age, at any time point (P > 0.05). CONCLUSION: Pterygium surgery with IRCF can be a safe and effective method for treating primary pterygium, especially when potential glaucoma filtration surgery is considered or when a proper superior bulbar conjunctiva is not available. Further multicenter prospective trials are needed to confirm the benefits of this technique.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.