Postoperative irradiation of primary or recurrent pterygium: Results and sequelae

Purpose: To evaluate the efficacy of postoperative beta irradiation and to analyze treatment sequelae in patients with primary and recurrent pterygium . Methods and Materials: From June 1986 to June 1998, 94 patients correspondi ng to 100 eyes received postoperative beta irradiation, Two groups of patie nts were treated: 37 eyes with primary pterygium (Group I) and 63 eyes with recurrent pterygium (Group II). Terson technique surgery was used in the m ajority of patients. Time between surgery and beta irradiation ranged from 2 to 48 h, Radiation doses and fractionation consisted of 30 Gy/3 fractions /5 days in 17 cases, 60 Gy/6 fractions/6 weeks in 80 cases, and 20 Gy/1 fra ction in 3 patients. Results: Fourteen of the 100 cases (14%) treated with surgery and adjuvant irradiation recurred, The overall crude local recurrence rates were 5.4% fo r Group I and 19% for Group II patients. The 5-year probability of local tu mor control was 83.5% for the whole group of patients, 94% for Group I, and 76.9% for Group II (p = 0.04). The early sequelae related to surgery or ir radiation were self limited and disappeared by 6 months after the end of th e treatment: ocular irritation (14 cases), scleral atrophy (5 cases), and n eovascularization (7 cases). A greater incidence of sequelae was observed i n Group II patients, but the difference between the groups was not statisti cally significant (p = 0.15). No significant correlation between treatment sequelae and treatment dose was noted: 29% sequelae with 30 Gy vs, 18.7% se quelae with 60 Gy (p = 0.32). No late complications have been observed. Conclusion: Adjuvant beta irradiation provides effective therapy for primar y pterygium, is somewhate less effective in patients with recurrent pterygi um, and is associated with a moderate rate of early and transient sequelae, (C) 2000 Elsevier Science Inc.