Yangfan Yang1, Minshi Pi2, Fasong Xu2. 1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China. 2. Department of Ophthalmology, Zhongshan Hospital,Xiamen University, Xiamen 361004, China.
Abstract
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.
RCT Entities:
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.