Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium
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Purpose: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for thetreatment of recurrent pterygium. Methods: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For eachaffected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvestedfrom the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed atleast six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complicationswere analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumabinjection. Results: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The meanstudy follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism andcorneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrencerate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observedfollowing the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7eyes. Conclusions: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygiumproduced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctivalbevacizumab injection given in cases of recurrence following surgery might be effective in preventingprogression of the pterygium.
Abstract
Purpose: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for thetreatment of recurrent pterygium. Methods: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For eachaffected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvestedfrom the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed atleast six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complicationswere analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumabinjection. Results: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The meanstudy follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism andcorneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrencerate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observedfollowing the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7eyes. Conclusions: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygiumproduced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctivalbevacizumab injection given in cases of recurrence following surgery might be effective in preventingprogression of the pterygium.
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