Effects of modified continuous blanket sutures on fixing auto-conjunctival transplantation in double-head pterygium surgery

Abstract

In this case series, large nasal and temporal pterygia from 112 patients (totaling 122 eyes) were concurrently excised. The temporal wound was covered using two pedicled transposition auto-conjunctival grafts applied using the double shoelace-type modified continuous blanket sutures (MCBS) technique. The nasal wound was covered by a free conjunctival graft from the same eye by using the MCBS technique. During the follow-up period (averaging 50.49 ± 20.53 months), all patients exhibited smooth ocular surfaces with minimal inflammatory reactions. By the end of the follow-up, there were no instances of graft loss or retraction. In addition, no major complications such as symblepharon in the superior fornices, corneoscleral ulcers, or conjunctivitis granulomas were reported. Transient graft edema was noted in three eyes (2.5%) within the first 2 postoperative weeks. Recurrence was only observed in 0.82% of cases (1 out of 122 eyes). This modified surgical technique offered mild inflammation and stable contraposition sutures, resulting in effective ocular surface reconstruction and a notably low recurrence rate for double-headed pterygium.