Extensive versus Limited Pterygium Excision with Conjunctival Autograft: Outcomes and Recurrence Rates

Abstract

Purpose: To compare the long-term outcomes and recurrence rate of extensive versus limited subconjunctival pterygium excision with conjunctival autograft. Methods: This retrospective study included 135 consecutive patients (161 eyes) who had pterygium excision with conjunctival autograft at the cornea performed at the cornea service of the Toronto Western Hospital. Ninety-one had limited pterygium excision, and 70 had extensive pterygium excision with conjunctival sparing. Main outcome measures included the recurrence rate. Results: The recurrence rate in the limited excision group was 12.1% compared with only 4.3% in the extensive pterygium excision group (p = 0.14). The mean time to recurrence was shorter with limited excision compared to extensive excision (4.0 vs. 5.3 months, respectively, p = 0.16). Limited pterygium excision had a hazard ratio of recurrence of 3.2 compared with the extensive excision method. Recurrence-free survival analysis showed a significant advantage for the extensive excision group (p = 0.045, log-rank test). Cox proportional hazards regression found that younger age (p = 0.0003), larger area of corneal involvement (p = 0.004), worse preoperative visual acuity (p = 0.01), and limited pterygium excision (p = 0.04) significantly increased the risk for recurrence. Conclusions: Both limited and extensive pterygium excision groups had low recurrence rates. The extensive subconjunctival pterygium excision group tended toward fewer recurrences, which occurred later.

KEYWORDS:

• extensive
• limited
• recurrence
• pterygium excision conjunctival autograft