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Editor,—Simple excision of a pterygium with or without a conjunctival autograft is a routine surgical procedure with generally minimal complications unless adjunctive antimitotic agents are used. We report an unusual and severe intraoperative complication of severe descemetocele formation in a patient who underwent a routine avulsion procedure1 2 for a primary pterygium.
CASE REPORT
A 47-year-old Malay woman with end stage renal failure on haemodialysis was found to have bilateral severe nasal primary pterygium, grade 4 in the right eye covering the pupillary axis and grade 3 in the left eye (Fig 1). In the right eye, areas of the cornea not directly affected by the pterygium invasion were also noted to be abnormal with diffuse peripheral stromal opacities and perilimbal superficial vascularisation. There was no history of previous ocular disease or trauma.
Right eye showing a nasal pterygium covering the pupillary axis.
A pterygium excision with a conjunctival graft was performed in the right eye via a simple avulsion technique. Surgery was …