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Published on: April 3, 2016
Comparative study of different β-radiation doses for preventing pterygium recurrence
Takayuki Yamada1, Hideki Mochizuki, Takahiro Ue
1Department of Ophthalmology and Visual Science, Hiroshima University Graduate School of Biomedical Sciences, and Department of Ophthalmology, Hiroshima Red Cross and Atomic Bomb Survivors Hospital, Hiroshima, Japan. tyamada-oph@umin.ac.jp
Purpose:
To compare the pterygium recurrence rates after treatment with two different β-radiation doses.
Methods And Materials:
A total of 84 patients with a mean age of 63.0±10.3 years (men, 48 eyes, and women, 47 eyes) and initially treated with β-radiation after pterygium excision were recruited. The mean follow-up period was 49.9±51.3 months. The patients were assigned to two dose groups: a high-dose (40 Gy) or a low-dose (20 Gy) group. The statistical significance of differences in patient age, pterygium size, and interval between surgery and radiotherapy were analyzed in the 20-Gy group using the Cox proportional hazard model at p<.05.
Results:
The high- and low-dose groups included 28 and 67 eyes, respectively. Pterygia recurred in 11 eyes, all in the low-dose group. The interval between surgery and radiotherapy was not a significant predictor of recurrence. Smaller pterygia had a lower risk of recurrence than pterygia that had encroached the pupillary area (pterygium located within one-third of the corneal radius from the limbus, corrected hazard ratio [HR], 0.069; 95% confidence interval [CI], 0.006-0.766; p=.030; pterygium extending beyond one-third of the corneal radius, corrected HR, 0.188; 95% CI, 0.018-0.696; p=0.019; and pterygium reaching the pupillary area, corrected HR, 0.184; 95% CI, 0.036-0.929; p=.040). Older age was marginally significant as a negative predictor of recurrence (HR, 0.943; 95% CI, 0.887-1.003; p=.061). No scleromalacia developed during the follow-up period.
Conclusions:
β-Radiation at 40 Gy was more efficacious than at 20 Gy in preventing pterygium recurrence without scleromalacia development, particularly for large-size pterygia and those in young patients.