A new conjunctival free flap design technique for pterygium surgery: Stamp technique

Purpose: To introduce a new conjunctival free flap design technique for pterygium surgery. Patients and methods: This study was a retrospective medical chart review of 20 patients (21 eyes) who underwent pterygium excision and conjunctival free flap by one surgeon. The following surgical procedures were used in conjunctival free flap design during pterygium surgery. We used the paper wrapper of 10-0 nylon, which will be used for the conjunctival suture, for making an imprint of the recipient defect. The paper was cut to an ellipsoidal shape of 2 to 3 mm larger than the recipient defect with utility scissors. The margin of the recipient defect was marked using a gentian violet pen. The paper was positioned carefully on the recipient defect and pushed down gently with a cotton tip. After removing the paper, the margin of the conjunctival defect was imprinted on the paper in the shape of a "C," The paper was cut according to the inner line of the "C" marking. The paper was placed on the superior conjunctiva. Conjunctival marking was applied according to the outline of paper with a pen. Results: The operation duration ranged from 64 min to 132 min (mean 88 min). The conjunctival free flap was identical to the recipient defect. Complications included recurrence (5%), wound dehiscence (19%), and granulation (5%). Conclusions: We think that this stamp technique is an efficient method for designing donor conjunctiva that is identical to the defect for free conjunctival transplantation during pterygium surgery.