AIM: To verify the advantages of an improved protocol for pterygium surgery(small incision removal)over a conventional protocol of this surgery.

METHODS: Totally 40 primary pterygium cases were divided into two groups(n=20 each)according to the protocols: small incision removal versus conventional removal. In our small incision removal, group 1, the pterygium body was cut open with a small incision firstly, through which the conjunctiva was separated from the underlying degenerated Tenon's layer; while in the conventional protocol, group 2, the whole head of pterygium was taken down before the separation. Then the head of pterygium was torn down in our protocol using a forceps instead of cutting it down with a blade, which was facilitated by a special corneal epithelial flap formation method. Surgery time, pain score and corneal wound healing were measured to provide objective comparison of outcome between the two protocols.

RESULTS: In the group using small incision removal, the average surgery time was 7.72min(or 48.9%)shorter than that of the control group using conventional protocol(P<0.001). The pain score was lower and the corneal wound was healed better in day 1 and 2 after the surgery in the small incision group(P<0.001). In addition, the surgery can be done by one surgeon using the small incision protocol, while the surgery using the conventional protocol requires two persons.

CONCLUSION: The small incision pterygium removal protocol was easier to perform and resulted in a better outcome than the conventional protocol.