The efficacy of fascial granuloma excision with conjunctival autografting after pterygium surgery

  • Hui-Ya Fan
  • Zi-Lin Chen


Background and objective

Pterygium has a high recurrence rate after simple excision, and fascial granuloma is one of the common complications of pterygium excision. This study aimed to investigate the treatment for the fascial granuloma.


In this study, the 36 eyes of 36 cases with fascial granuloma after pterygium excision were collected and divided into two groups to receive granuloma excision and conjunctival autografting or simple granuloma excision. The patients in the treatment group containing 20 cases received granuloma excision and conjunctival autografting, while the patients in the control group containing 16 cases received simple granuloma excision.


The pathology examination results showed that all the removed granulomas were inflammatory granulation tissues that without bacterial infection. After 12 months’ follow-up, there was no recurrence of fascia granuloma and pterygium in the treatment group, in which the cure rate was up to 100%. In the control group, 6 cases experienced a recurrence of the granuloma fascia 2~3 weeks after operation; after further granuloma excision and conjunctival autografting, pterygium recurred in 8 cases.


The fascial granuloma excision with conjunctival autografting is effective and safe in treating fascial granuloma after pterygium surgery, which contributes to reducing the recurrence of pterygium.


Pterygium Fascial granuloma excision Conjunctival autografting 


Compliance with ethical standards

Competing interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.


  1. 1.
    Tano T, Ono K, Hiratsuka Y et al (2013) Prevalence of pterygium in a population in Northern Japan: the locomotive syndrome and health outcome in Aizu Cohort Study. Acta Ophthalmol 91:232–236CrossRefGoogle Scholar
  2. 2.
    Desmouliere A, Redard M, Darby I et al (1995) Apoptosis mediates the decrease in cellularity during the transition between granulation tissue and scar. Am J Pathol 146:56–66PubMedPubMedCentralGoogle Scholar
  3. 3.
    Sibbald RG, Williamson D, Orsted HL et al (2000) Preparing the wound bed—debridement, bacterial balance and moisture balance. Ostomy Wound Manage 46:14–22 24–18, 30–15; quiz 36–17PubMedGoogle Scholar
  4. 4.
    Reinke JM, Sorg H (2012) Wound repair and regeneration. Eur Surg Res 49:35–43. CrossRefPubMedGoogle Scholar
  5. 5.
    Vorstenbosch J, Gallant-Behm C, Trzeciak A et al (2013) Transgenic mice overexpressing CD109 in the epidermis display decreased inflammation and granulation tissue and improved collagen architecture during wound healing. Wound Repair Regen 21:235–246. CrossRefPubMedGoogle Scholar
  6. 6.
    Yamane T, Nakagami G, Yoshino S et al (2015) Hydrocellular foam dressings promote wound healing associated with decrease in inflammation in rat periwound skin and granulation tissue, compared with hydrocolloid dressings. Biosci Biotechnol Biochem 79:185–189. CrossRefPubMedGoogle Scholar
  7. 7.
    Martins TGDS, Costa ALFDA, Alves MR et al (2016) Mitomycin C in pterygium treatment. International Journal of Ophthalmology 9:465PubMedPubMedCentralGoogle Scholar
  8. 8.
    Prabhasawat P, Barton K, Burkett G et al (1997) Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 104:974CrossRefPubMedGoogle Scholar
  9. 9.
    Zhang L, Wang CC (2014) Inflammatory response of macrophages in infection. Hepatobiliary Pancreat Dis Int 13:138–152CrossRefPubMedGoogle Scholar
  10. 10.
    Yun-Shain L, Annette W, David W et al (2012) Wound healing in development. Birth Defects Res C Embryo Today 96:213–222CrossRefGoogle Scholar
  11. 11.
    Nigwekar SP, Chaudhari SV, Gupte CP et al (2014) Pyogenic granuloma: post operative complication of pterygium surgery. International Journal of Medical Research & Health Sciences 3:759CrossRefGoogle Scholar
  12. 12.
    Ozsutcu M, Ayintap E, Akkan JC et al (2014) Repeated bevacizumab injections versus mitomycin C in rotational conjunctival flap for prevention of pterygium recurrence. Indian J Ophthalmol 62:407–411CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Li J, Zhou DH, Lu LN (2011) Clinical observations of conjunctival autografting combined with mitomycin C in treatment of pterygium. Journal of Shanghai Jiaotong University 31:1102–1104Google Scholar
  14. 14.
    Prabhasawat P, Tesavibul N, Leelapatranura K et al (2006) Efficacy of subconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium. Ophthalmology 113:1102–1109CrossRefPubMedGoogle Scholar
  15. 15.
    Kasetsuwan N, Reinprayoon U, Satitpitakul V (2015) Prevention of recurrent pterygium with topical bevacizumab 0.05% eye drops: a randomized controlled trial. Clin Ther 37:2347–2351CrossRefPubMedGoogle Scholar
  16. 16.
    Dong MC, Kim KH, Choi HJ et al (2012) A comparative study of the effect of fibrin glue versus sutures on clinical outcome in patients undergoing pterygium excision and conjunctival autografts. Korean Journal of Ophthalmology Kjo 26:407–413CrossRefGoogle Scholar
  17. 17.
    Detorakis ET, Zaravinos A, Spandidos DA (2010) Growth factor expression in ophthalmic pterygia and normal conjunctiva. Int J Mol Med 25:513–516CrossRefPubMedGoogle Scholar
  18. 18.
    Kuo CH, Miyazaki D, Yakura K et al (2010) Role of periostin and interleukin-4 in recurrence of pterygia. Invest Ophthalmol Vis Sci 51:139–143CrossRefPubMedGoogle Scholar
  19. 19.
    Talghini S, Shenasi A (2013) Concomitant examination of inflammation and angiogenesis in the pathogenesis of primary moderate pterygium in a well-designed case-control study. Pakistan Journal of Biological Sciences Pjbs 16:1046–1050CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Ophthalmology CenterHuizhou Municipal Central HospitalHuizhouPeople’s Republic of China

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