Purpose. To introduce an improved technique of pterygium surgery and to com
pare postoperative results between this technique and previous techniques.
Methods. In a retrospective survey, the, records of 216 consecutive eyes wi
th primary pterygium that underwent surgery by three different techniques w
ere reviewed. The new technique (mini-flap technique) involves making a sma
ll excision of the pterygium body, removing the pterygium head by scraping
with forceps, applying mitomycin C (MMC), and performing a small conjunctiv
al transposition flap. The previous technique (large-flap technique II) inv
olved making a large excision in the pterygium body, removing the pterygium
head with a knife, applying MMC, and performing a large transposition flap
. Large-flap technique I is the same as large-flap technique II except for
the use of intraoperative MMC. The recurrence rate of each technique was es
timated by the Kaplan-Meier life table analysis. Results. The recurrence ra
tes estimated at I year after surgery were 15.5% in large-flap technique I,
4.2% in large-flap technique II, and 0% in the mini-flap technique. Large-
flap technique II or the mini-flap technique had significantly lower recurr
ence rates compared with large-flap technique I (p = 0.02 and p < 0.01, res
pectively). The mini-flap technique had a significantly lower incidence of
conjunctival scarring or granuloma compared with large-flap technique I and
large-flap technique II (p = 0.05 and p = 0.03, respectively.) Conclusions
. The mini-flap technique was useful for preventing recurrence and was tech
nically easier and induced fewer postoperative complications than large-fla
p techniques I and II.