Esra VURAL, Erdem ERİS, Ali Riza Cenk ÇELEBİ

Evaluation of the recurrence rates and the factors affecting recurrence in pterygium surgery with autograft transplantation

Aim: The objective of this study is to determine the recurrence rates in pterygium surgery with autograft transplantation and toinvestigate the factors affecting recurrence.Material and Methods: This study was carried out in our clinics between July 2015 and March 2017, and patients who had undergonepterygium surgery with autograft were examined retrospectively. Forty-six patient were included in the study. Demographic data ofthe patients, comorbidities, follow-up periods, complications, size of the pterygium, recurrence rate, rate of inflammation persistingin the autograft at week 2 were recorded.Results: Forty-six patients who had undergone pterygium operations with autografts were included in this study The mean age ofthe patients was 46.6±15.6 y. Recurrence was seen in 13.3% (6/46) patients during the mean follow-up period of 12.06±4.5 months.The mean period of time elapsed till recurrence was 4.3±1.3 months. The mean pterygium size was 3.9±0.6 mm. Discomfort stillcontinuing at week 2 was seen with a rate of 22.2%. Regarding to the complications; Tenon cyst was seen in 6.7% (3/46), graft edemain %8.9% (4/46) and dellen was seen in 4.4% (2/46). Recurrence rate was 7.4% in females and while it was 22.2% in males, whichwas higher as compared to females.Conclusion: Pterygium surgery using conjunctival autograft is a safe and effective technique; and while recurrence can be seen witha low rate, recurrence is affected by factors including age, gender and size of the pterygium.

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1. Tomidokoro A, Miyata K, Sakaguchi Y, et al. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology 2000;107:1568-7.
2. Errais K, Bouden J, Mili-Boussen I, et al. Effect of pterygium surgery on corneal topography. Eur J Ophthalmol 2008;18:177-81.
3. Demirok A, Simsek S, Ozdemir M, et al. Effect of pterygium surgery on corneal topography. Cornea 2005;24:505-6.
4. Ozer A, Yildirim N, Erol N, et al. Long-term results of bare sclera, limbal-conjunctival autograft and amniotic membrane graft techniques in primary pterygium excisions. Ophthalmologica 2009;223:269-73.
5. Prabhasawat P, BartonK, BurkettG, et al.Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104:974-85.
6. Alaniz Cancino F. The use of beta irradiation in the treatment of pterygia. OphthalmicSurg 1982;13:1022- 25.
7. Helal M, Messiha N, Amayem A, et al. Intraoperative mitomycin-C versus postoperative topical mitomycin-C drops for the treatment of pterygium. Ophthalmic Surg Lasers. 1996;27:674-8.
8. Tekin NF, Kaynak S, Saatci AO, et al. Preserved human amniotic membrane transplantation in the treatment of primary pterygium.Ophthalmic Surg Lasers 2001;32:464-9.
9. Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985;92:1461-70.
10. Nakasato H, Uemoto R, Mizuki N. Treatment of pterygium by ligation and bevacizumab injection. Cornea 2012;31:1339-41.
11. Yeung SN, Rubenstein D, Price AJ, et al. Sequential pterygium excision with conjunctival autograft in the management of primary double-headed pterygia. Can J Ophthalmol 2013;48:521-3.
12. Tan DT, Chee SP, Dear KB, et al. Effect of pterygium morphology on pterygium recurrence in acontrolled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 1997;115:1235-40.
13. Chen PP, Ariyasu RG, Kaza V, et al. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120:151-60.
14. Kocamis O, Bilgec M. Evaluation of the recurrence rate for pterygium treated with conjunctival autograft. Graefes Arch Clin Exp Ophthalmol 2014;252:817-20.
15. Prabhasawat P, Barton K, Burkett G, et al. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104:974-85.
16. Fernandes M, Sangwan VS, Bansal AK,et al. Outcome of pterygium surgery: analysis over 14years. Eye (Lond) 2005;19:1182-90.
17. Dua HS, Gomes JA, King AJ, et al. Amniotic membrane use in ophthalmology.Curr Opin Ophthalmol 2005;16:233-40.
18. Prabhasawat P, Barton K, Burkett G, et al. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104:974-85.
19. Ugurbaş SH, Kargı Ş, Alpay A, et al. Sutureless conjunctival autograft in pterygium treatment. Turk J Ophthalmol 2007;37:333-7.
20. Cha DM, Kim KH, Cho HJ, et al. A comparative study of the effect of fibrin glue versus sutures on clinical outcome in patients undergoing pterygium excision and conjunctival autografts. Korean J Ophthalmol 2012;26:407-13.
21. Onay MP, Eğrilmez S, Yağcı A. Non-recurrence complications of pterjium surgery. Turk J Ophthalmol 2011;41:151-5.
22. Yüksel B, Unsal SK, Onat S. Comparison of fibrin glue and suture technique in pterygium surgery performed with limbal autograft. Int J Ophthalmol 2010;3: 316-20.