Different therapeutic approaches and outcome in the treatment of pterygium

Purpose. This study was initiated to investigate the role of different ther apeutic modalities in the outcome of the surgical treatment of pterygium. Methods. The results of treatment of pterygia with a variety of surgical te chniques were studied in 56 eyes (49 patients) operated on at Bristol Eye H ospital during a period of five years. The surgical techniques included sim ple excision; bare sclera; conjunctival autograft; sliding conjunctival fla p; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys. Results. The incidence of recurrence was 23.2% for the 43 treated primary p terygia, and 23% for the 13 recurrent pterygia. All recurrences occurred be tween 2.5 and 11 months postoperatively. None of the II cases where additio nal beta irradiation was used showed any recurrence or other complication w ithin the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed signif icantly lower recurrence rate (p < 0.001) compared to those cases treated w ith surgical excision alone. Conclusions. Beta irradiation as a complement to surgical treatment of pter ygium, is successful in treating high risk cases such as reoperations, wher eas for the majority of primary pterygia surgical excision alone is adequat e. Additionally, follow up of one year will reveal any recurrences.