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KMID : 0360220180590121114
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Journal of the Korean Ophthalmological Society
2018 Volume.59 No. 12 p.1114 ~ p.1121
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Long-term Outcomes of Conjunctivo-limbal Autograft Alone and Additional Widening of Limbal Incision in Recurrent Pterygia
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Chung In-Kwon
Kim Jin-Hyoung
Lee Jong-Hyun
Lee Do-Hyung
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Abstract
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Purpose: We report the clinical outcomes of patients undergoing additional widening of the limbal incision to prevent disease recurrence after conjunctivo-limbal autograft combined with pterygial excision.
Methods: We retrospectively compared 95 eyes with primary and 12 eyes with recurrent pterygia randomized to treatment via two surgical methods: conjunctivo-limbal autograft alone and combined with widening of the limbal incision to allow for pterygial removal. We widened the limbal incisions by 1 mm on both the superior and inferior limbal margins and removed the pterygia. The outcomes were compared between 39 eyes undergoing conjunctivo-limbal autograft alone and 68 eyes undergoing conjunctivo- limbal autograft with widening of the limbal incision.
Results: The mean overall postoperative follow-up period was 29.6 ± 10.5 months and conjunctivo-limbal autograft alone group was 27.4 ± 11.5 months, combined with widening of the limbal incision group was 30.7 ± 9.7 months. Six pterygia (15.4%; four primary and two recurrent) developed in those undergoing conjunctivo-limbal autograft alone and two (2.9%; one primary and one recurrent) in those undergoing additional widening of the limbal incision; the recurrence rate differed significantly between the two groups (p < 0.05). In the group treated with conjunctivo-limbal autograft alone, the mean time to development of a new primary pterygium was 6.3 ± 3.4 months and that to development of a recurrent pterygium 4.3 ± 2.5 months; the respective values for the group undergoing additional widening of the limbal incision were 12.1 ± 2.6 and 8.4 ± 4.6 months; the recurrence rates differed significantly (p < 0.05).
Conclusions: Conjunctivo-limbal autograft with additional widening of the limbal incision used to treat both new primary and recurrent pterygia was more effective in terms of reducing pterygial recurrence than conjunctivo-limbal aAutograft alone.
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KEYWORD
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Limbal, Pterygium, Recurrence, Transplantation, Widening
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