Abstract
Conjunctival procedures include a bridge conjunctival flap (Gundersen flap), pterygium surgery, conjunctival excision for conjunctivochalasis, limbal stem cell transplantation, and tumor removal. In a conjunctival flap procedure, a hinged flap of conjunctiva is created to cover an unstable or painful corneal surface. Conjunctival flaps, partial or total, have remained an effective procedure for the treatment of challenging ocular surface disorders in patients with poor visual prognosis. Pterygium surgery dates back to 1000 BC, but “modern” pterygium surgery in the 1850s emphasized the importance of conjunctival closure over the epibulbar defect. Since then, the use of autografts, amniotic membranes, fibrin glue, and mitomycin C has improved efficiency and outcomes in pterygium excision. Conjunctivochalasis, an entity of excess conjunctival laxity, at times may cause symptoms of ocular surface irritation and, if symptomatic, may be managed by conjunctival cautery or resection. This chapter reviews the salient features of the principles of conjunctival surgeries encountered by the comprehensive ophthalmologist.