Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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.