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Pterygium treated with excision and postoperative beta irradiation
R B Wilder1, J M Buatti, J M Kittelson
1Department of Radiation Oncology, University of Arizona College of Medicine, Tucson.
International Journal of Radiation Oncology, Biology, Physics
|January 1, 1992
Summary
Postoperative beta irradiation after pterygium excision significantly reduces recurrence rates in desert climates. This treatment offers a high local control rate and satisfactory cosmetic outcomes with minimal complications.
Area of Science:
- Ophthalmology
- Radiation Oncology
Background:
- Pterygia are a common eye condition, particularly in hot, dry, dusty climates.
- Recurrence after surgical excision is a significant clinical challenge.
- The southwestern United States desert climate is associated with high pterygium incidence and recurrence.
Purpose of the Study:
- To evaluate the efficacy of postoperative beta irradiation in preventing pterygium recurrence.
- To assess the local control rates and cosmetic outcomes of this treatment modality.
Main Methods:
- Retrospective study of 338 patients with pterygia treated between 1974 and 1990.
- Surgical excision followed by beta irradiation within 24 hours.
- Standard fractionation: 3 weekly 800 cGy fractions; follow-up for local control and recurrence.
Main Results:
- Overall recurrence rate was 16%.
- Crude local control rate was 88% (225/258) at 6 months; 5-year Kaplan-Meier estimate was 84%.
- Previously untreated pterygia had better control rates than recurrent ones (p=0.005); 86% satisfactory cosmetic results with low morbidity.
Conclusions:
- Postoperative beta irradiation, when fractionated, is effective in reducing pterygium recurrence after surgical excision.
- This adjuvant therapy achieves high local control rates with good cosmetic results and minimal severe complications.
- Findings support the use of beta irradiation as an adjunct to surgery for pterygium management, especially in high-risk populations.