Pterygium excision with conjunctival autograft and subconjunctival amniotic membrane as antirecurrence agents

To determine the outcome of pterygium excision with a conjunctival autograft when the adjunctive use of a subconjunctival graft of amniotic membrane is employed to reduce fibrosis and recurrence after surgery.

This is a retrospective, noncomparative study of postoperative outcomes.

Eighty-four patients totalling 101 eyes with clinically significant pterygia that warranted surgical excision.

Surgeries were performed at South Orange County Outpatient Surgery Center (San Clemente, Calif.) between June 6, 2006, and October 23, 2013, by a single surgeon (J.A.H.). Patients were included in the study according to the need for pterygium surgery and the type of surgery performed. Exclusion criteria included patients with recurrent pterygium, those with pseudopterygium, and those whose treatment plan included prophylactic mitomycin during or after surgery. Initial pterygia measurements and postoperative findings were taken through standard slit-lamp examinations.

Pterygium recurrence was defined as growth greater than 1 mm onto the corneal limbus at or after 6 months. There was 1 case of pterygium recurrence for a recurrence rate of 0.99% ± 1.93% (n = 101, p = 0.05). The mean extent of preoperative horizontal encroachment of pterygium on the cornea was 2.4 ± 0.87 mm.

Pterygium excision with a conjunctival autograft and prophylactic placement of a subconjunctival amniotic membrane graft has a low recurrence rate with minimal added surgical time and minimal added risk to the patient and has merit as a surgical technique.