Table 1 Assessment Scale for Pterygium Surgery

Preoperative preparation

Failed to wear hat, mask and gloves

Failed to wear two of the three

Failed to wear one of the three

Wearing hat, mask and gloves correctly

Wearing hat, mask and gloves smoothly

Microscope use

Off-center and refocusing constantly

Off-center and refocusing frequently

Out of center and focus occasionally

Stay in center and focus constantly

Fluid moves with microscope

Instrument handling

Constantly makes tentative and awkward moves with inappropriate use of instruments

Frequently makes tentative and awkward moves with instruments

Fair use of instruments but occasionally stiff or awkward

Competent use of instruments

Fluid moves with instruments

Local anesthesia

Unable to complete; does not understand the injection site and dose of lidocaine

Barely completed; the dose and site were not appropriate

Almost completed; the dose and site were almost appropriate

Completed; the dose and site were appropriate

Smoothly completed; injection of anesthetics under bulbar conjunctiva of pterygium body with accurate dose

Conjunctival incision

Failed to make the incision

Barely made the incision; the location and length were not appropriate

Almost completed; the location and length were almost appropriate

Completed; the location and length were appropriate

Smoothly completed; incision was made 1 mm outside and parallel to the limbus. The length of the incision was 0.5 mm across the upper and lower edges of pterygium

Pterygium head dissection

Failed to dissect

Less than 60 % of pterygium head was dissected from cornea

60 to 80 % of pterygium head was dissected from cornea

More than 80 % of pterygium head was dissected from cornea

Fully dissected pterygium head from cornea in its anatomical plane

Pterygium body separation and dissection

Failed to separate pterygium body from conjunctiva and sclera

Less than 60 % of pterygium body was separated and dissected from conjunctiva

60 to 80 % of pterygium body was separated and dissected from conjunctiva

More than 80 % of pterygium body was separated and dissected from conjunctiva

Fully dissected pterygium body from conjunctiva without damaging episcleral vessels

Removal of subconjunctival tissue

Failed to remove

Less than 60 % of subconjunctival tissue was removed

60 to 80 % of subconjunctival tissue was removed

More than 80 % of subconjunctival tissue was removed

Full removal of fibrovascular tissue leaving a thin and smooth conjunctival rim

Hemostasis

Failed to complete hemostasis; the operation field is unclear

Barely completed, the hemostasis was not timely and effective

Almost completed, the hemostasis was almost timely and effective

Completed, the hemostasis is timely and effective

Perfectly completed hemostasis with minimal use of cautery

Conjunctival autograft acquisition

Failed to obtain

The size and location of the conjunctival autograft was not appropriate; irregular cut in borders or buttonhole of the graft

The size and location of the conjunctival autograft was almost appropriate; some residual Tenon’s on the graft

The size and location of the conjunctival autograft was appropriate; few residual Tenon’s on the graft

Perfect size and location of the conjunctival autograft; thin and even graft

Autograft suturing

Failed to suture, or sutured the graft upside and down

Sutures are completed with difficulty; the graft is not well secured by sutures

Sutures are completed with little difficulty; the graft is almost secured by sutures

Sutures are completed properly; the graft is secured by sutures

Smooth and perfect suturing with good space and tension

Postoperative clean up

Failed to clean the table. Failed to settle the microscope and instruments. Failed to remove hat, mask and gloves properly

Failed to do two of the three things

Failed to do one of the three things

Completed all of the three things

Disposed of medical waste in correct bins. Settled the microscope and instruments. Removed the hat, mask and gloves correctly