The procedure of transplanting healthy conjunctiva onto eyes with damaged ocular surface epithelium was first described by Thoft in 1977. Today, conjunctival
autografting is widely used in
pterygium surgery and has been shown to be both safe and effective in reducing
pterygium recurrence. Several randomized, controlled, clinical trials have been reported in the literature, and conjunctival
autografting is now recognized to have an efficacy equal to that of such adjunct
therapies as beta-irradiation and
mitomycin C, and yet it is safer than these treatments. Recent modifications of the conjunctival autograft include the conjunctival rotation autograft and the inferior conjunctival transposition flap, both of which have been reported to be associated with low rates of recurrence. With the discovery of the role of limbal stem cells in the maintenance and stability of the corneal surface, recent forms of ocular surface
transplantation that have supplanted Thoft's conjunctival
transplantation procedure include limbal autograft
transplantation and limbal allograft
transplantation. In addition, the adjunct use of human amniotic membrane in these ocular surface
transplantation procedures has improved success and survival rates in the management of ocular surface disease, which still presents significant challenges to clinicians today.