COMPARISON OF CONJUNCTIVAL AUTOGRAFTS, AMNIOTIC MEMBRANE GRAFTS, AND PRIMARY CLOSURE FOR PTERYGIUM EXCISION

Objectives: The purpose of the study is to determine whether amniotic membrane can be used as an alternative to conjunctival autograft after pterygium excision. Design: A prospective study of amniotic membrane grafts (group A) and primary closure (group B) was compared retrospect ively with conjunctival autografts (group C) in patients with pterygia . Participants: Group A included 46 eyes with primary pterygia and 8 e yes with recurrent pterygia, group B had 20 eyes with primary pterygia , and group C consisted of 78 eyes with primary and 44 eyes with recur rent pterygia. Intervention: For the above three different surgeries, the amount of tissue removed was estimated from histopathologic analys is, and the result was evaluated by clinical examination. Main Outcome Measures: Recurrence, survival analysis, and final appearance were co mpared. Results: In group A, the recurrence rate was 10.9%, 37.5%, and 14.8% for primary, recurrent, and all pterygia, respectively (mean fo llow-up, II months), These three rates were significantly higher than 2.6%, 9.1%, and 4.9% noted in group C (mean follow-up, 23 months) (P < 0.001, 0.018, and 0.01, respectively). However, the latter recurrence rate was significantly lower than 45% (mean follow-up, 5.2 months) in group B for primary pterygia (P < 0.001), The onset of recurrence was delayed significantly in group C as compared with that of groups A an d B. Conclusions: The relatively low recurrence rate for primary ptery gia allows one to use amniotic membrane transplantation as an alternat ive first choice, especially for advanced cases with bilateral heads o r those who might need glaucoma surgery later.