1. Hongseok Yang, MD Department of Ophthalmology, Ajou University School of medicine, Suwon, Korea The author has no financial interest

2. Purpose To evaluate the efficacy of conjunctival autograft transplantation with amniotic membrane transplantation in primary pterygium surgery To compare postoperative recurrence rates between conjunctival autograft transplantation only and conjunctival autograft transplantation with amniotic membrane transplantation in primary pterygium surgery.

3. Patients and methods Patients with pterygium who underwent conjunctival autograft transplantation From January, 2001 to May, 2009 in Department of ophthalmology, Ajou university medical center Single surgeon Retrospective study, chart review

4. Patients and methods 2 groups (66 eyes of 63 patients) Group 1: conjunctival autograft transplantation only 23 eyes of 22 patients Group 2: conjunctival autograft transplantation with amniotic membrane transplantation 43 eyes of 40 patients

5. Patients and methods Removal of pterygium from cornea with Beaver blade.

6. Patients and methods Tenon and subconjunctival fibrovascular tissue were undermined and excised extensively with a pair of spring scissors.

7. Patients and methods Marked the donor conjunctiva with Gentian violet made to measure the size of conjunctival defect.

8. Patients and methods Conjunctival graft was attached to the conjunctival edges and episclera with interrupted 10–0 Nylon sutures

9. Patients and methods Amniotic membrane was cut a proper-sized graft, which would cover the conjunctival transplantation area and corneal epithelial defect area. The membrane was placed over the epithelial side on top. Pinch together the membrane and conjunctiva, interrupted suture was done with 10-0 Nylon.

10. Results M:F = 9:13 (group 1) 17:23 (group 2) Average follow up period group 1 : 11.7 ± 24.2 month group 2 : 12.4 ± 16.8 month Average recurrence interval group 1 : 3.2 (1 – 4)month group 2 : 5 (4- 6)month

11. Results Recurrence of pterygium was observed in 5 of 23 eyes that received conjunctival autograft transplantation only. (21.7%) Recurrence of pterygium was observed in 2 of 43 eyes that received conjunctival autograft transplantation and amniotic membrane transplantation.(4.6%) Therer is a statistically significant difference between two groups.(p<0.05) No major complications such as necrotizing scleritis, sclera ulcer, corneal perforation were noted in either group after surgery.

12. Conclusion This study showed that receiving both conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery has a lower recurrence rate than conjunctival autograft transplantation only. Therer is no major complications such as necrotizing scleritis, sclera ulcer, corneal perforation were noted after surgery.