Observation of long-term efficacy of corneal limbal conjunctival autografts in microscopy treatments of pterygium.

PURPOSE: To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium.

METHODS

This random control study included 63 patients (63 eyes) with primary pterygium. These were randomly divided into a group with corneal limbal conjunctival autograft combined with pterygium excision (group A) and a group with pterygium excision with exposed sclera (group B) and subjected to long-term follow up. The surgical outcomes were classified and evaluated (grade I-IV). Several indexes were analyzed, including ocular surface irritation symptom, tear film stability, surgical complication, and recurrence rate.

RESULTS

The follow up ranged from 24 to 38 months, (26.9+/-3.4) months on average. No recurrence was noted at 6 weeks postoperatively. At 6 months postoperatively, the recurrence rate of pterygium was 5.2% in group A and 8.0% in group B. At 1 year postoperatively, the recurrence rate in group A was 10.5% and 20.0% in group B. At the end of follow up, the recurrence rates were 13.1% in group A and 24.0% in group B. No statistical significance was found between two groups regarding the recurrence rates at each time point (P>0.05). After the follow up (> 2 years), the severity of ocular surface conditions was significantly milder in patients in group A than in group B (P<0.01). No statistically significant differences were noted between the two groups at 6 weeks, 6 months, and 1 year after surgery. No statistically significant differences were observed between the two groups regarding postoperative tear film break-up time. Fewer postoperative complications and milder ocular surface irritation symptoms occurred in patients in group A.

CONCLUSION

Corneal limbal conjunctival autograft combined with pterygium excision yields sound long-term efficacy and a low recurrence rate and induces only mild damage on the ocular surface when used as a treatment for pterygium.