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Comparison of Surgical Techniques for Recurrent Pterygium

Title of Article: Comparison of surgical techniques for recurrent pterygium


Background:

A pterygium, sometimes called Surfer’s Eye, is a raised, wing-like growth of the conjunctiva that usually starts from the canthus and may cross the cornea. The eponym Surfer’s Eye arises from the similarity in environmental causes of pterygium that surfers are exposed to, specifically sun, wind and dust. Primary pterygium is most effectively treated with conjunctival autograft (CAU) and amniotic membrane grafting (AMG) with mitomycin-C (MMC), however the optimal surgical treatment in the context of recurrent pterygium is not well established. Therefore, this study investigates the recurrence rates after recurrent pterygium excision surgery via CAU or AMG with or without MMC.


Study Key Points:

The authors conducted a retrospective review of adult patients who received pterygium excision surgery at Boston Medical Center over a 10 year period (January 1999 - July 2019). 41 eyes of 38 patients met the criteria and the observed postoperative recurrence rates were as follows: 0% with CAU + MMC (0 of 8 eyes), 17.7% with CAU (3 of 17 eyes), 45.5% with AMG + MMC (5 of 11 eyes) and 80.0% with AMG (4 of 5 eyes). The rate was significantly lower in the CAU group than the AMG group both with adjuvant MMC (p=0.045) and without (p=0.021). The presence or exclusion of MMC was not statistically significant in either the CAU group (p=0.052) or AMG group (p=0.31). The use of MMC resulted in 1 report of complete amniotic membrane melt.


Conclusion and Relevance:

The results of this study suggest CAU is more favourable than AMG to treat recurrent pterygium with fewer postoperative recurrences. Intraoperative MMC may also prevent recurrence but was not statistically significant and may cause complications.


Reference:

Kim YJ, Rao R, Lee HJ. Comparison of surgical techniques for recurrent pterygium. Can J Ophthalmol. 2022 Jun 21:S0008-4182(22)00175-2. doi: 10.1016/j.jcjo.2022.05.011. Epub ahead of print. PMID: 35750200.


Date of Article Publication: June 21, 2022


Article Summary by: Neil Kamra


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