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Sang Beom Han, Jeong-Min Hwang, Joon-Young Hyon, Seung-Jun Lee, Jin Seok Choi; Risk Factors for Recurrence after Pterygium Surgery: An Image Analysis Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3492.
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© ARVO (1962-2015); The Authors (2016-present)
Although prediction of the risk of recurrence after pterygium surgery is important, consensus on the risk factors of recurrence has not been established yet. This retrospective study was performed to determine the risk factors of recurrence of pterygium using automated image analysis.
This study included 175 eyes of 175 consecutive patients who underwent pterygium excision and limbal conjunctival autograft. Demographic variables including age and sex were collected. Image analysis was performed using preoperative anterior segment photographs. Image J software (ver. 1.48, NIH, Bethesda, MD, USA) was used for calculation of relative length (RL; horizontal length of pterygium invading cornea / horizontal corneal diameter), relative width (RW; width of pterygium invading cornea / vertical corneal diameter) and relative area (RA; area of pterygium invading cornea / total corneal area). Vascularity index (VI; degree of vascularity) of the pterygial region invading the cornea was determined using software that uses the contrast-limited adaptive histogram equalization algorithm which automatically extracts vasculature and scores the degree of vascularity in numeric values ranging from 0 to 100. In all patients, recurrence of pterygium was determined at 1 year after surgery. Association between these factors and recurrence was evaluated with univariate and multivariate analyses.
Recurrence at 1 year was reported in 16.6% (21 / 175) of the patients. Univariate analysis showed that RL (29.7 ± 10.4 (mean ± SD)% vs. 20.8 ± 10.0%, P<0.001), RW (51.9 ± 14.0% vs. 43.5 ± 11.5%, P =0.005), RA (15.4 ± 8.9% vs. 9.6 ± 5.9%, P = 0.002) and VI (39.6 ± 13.9 vs. 21.5 ± 13.7, P<0.001) were significantly associated with increased risk of recurrence, while age (59.9 ± 9.5 yr vs. 59.1 ± 12.1 yr, P = 0.711) and sex (M : F = 12 : 17 vs. 68 : 78, P =0.686) had no significant association with recurrence. In multivariate analysis, only VI (P<0.001) had significant correlation with recurrence, whereas the associations between recurrence and age (P=0.080), RL (P=0.955), RW (P=0.689) or RA (P=0.428) were not significant. Patients with VI ≥ 30 had significantly higher recurrence rate than those with VI < 30 (35.3% (24 / 68) vs. 4.7% (5 /107), Odd ratio = 11.13 (95% confidence interval, 3.99 – 31.05), P<0.001).
Increased vascularity of the pterygium involving the cornea was associated with a higher risk of recurrence.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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