Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium.
- Author:
Jun Seok LEE
1
;
Sang Won HA
;
Sung YU
;
Gwang Ja LEE
;
Young Jeung PARK
Author Information
- Publication Type:Original Article
- Keywords: Autografts; Bevacizumab; Pterygium
- MeSH: Astigmatism; Autografts*; Bevacizumab; Cicatrix; Edema; Follow-Up Studies; Granuloma, Pyogenic; Humans; Male; Medical Records; Postoperative Complications; Pterygium*; Recurrence; Tissue Donors; Transplants; Visual Acuity
- From:Korean Journal of Ophthalmology 2017;31(6):469-478
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study 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 and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
