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Dan Yin, Olivia L. Lee; Risk Factors for Pterygium Recurrence after Primary Excision. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3367.
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To identify the risk factors, including preoperative characteristics and operative technique, associated with recurrence after primary pterygium excision. The post-operative recurrence rates for various operative techniques are described.
A retrospective review of eyes that underwent primary pterygium excision at New York Eye & Ear Infirmary between January 2003 and November 2008 was performed; only eyes which had at least 6 months of postoperative follow-up were included. Data was collected regarding demographics, clinical characteristics, intra-operative technique, adjunctive therapy, postoperative management, and complications including recurrence. Data was analyzed using Chi-Square testing, Fisher's exact test and logistic regression analysis.
This study includes 205 eyes of 191 patients of mean age 51.0 +/- 41.12 years; 53% of the patients were male and 89% were Hispanic. The overall incidence of recurrence rate after pterygium excision was 10.24%. Large-sized (>75th percentile) pterygia were more likely to recur (15.9%) compared to small-sized (< 25th percentile) pterygia (4.3%), although this was not statistically significant (p= 0.064). With respect to operative technique, the lowest incidence rate was associated with conjunctival autograft (9.93%) and amniotic membrane transplant (12.5%). The highest incidence of recurrence was found to occur with bare sclera approach (14.3%). Intraoperative uses of mitomycin C application and subconjunctival steroid injection were not associated with statistically significantly lower recurrence rate.
Pterygia infrequently recur following primary excision with current surgical techniques, particularly conjunctival autograft. When evaluating pterygia, pterygium size should be taken into account, as large size may be considered a risk factor for recurrence.
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