Background: Treatment outcome in patients with pterygium following bare-sclera excision and conjunctival autograft (CAG) with and without phototherapeutic keratectomy (PTK). Methods: Retrospective comparative analysis of 81 eyes, with primary and recurrent pterygia, that were analyzed for recurrence, best-corrected visual acuity (BCVA) and astigmatism in primary (P1 without PTK, P2 with PTK) and recurrent pterygia (R1 without PTK, R2 with PTK). BCVA and astigmatism were compared in patients with simple CAG alone (group I) or in combination with PTK (group II). Results: Recurrence rates were 4.7, 11.6, 16.2, 23.2 and 32.5% at 3, 6, 12, 24 and >24 months (P1), 7.1% at >24 months (P2). Recurrence rates were 5.3, 10.5, 21.1, 21.1 and 26.3% at 3, 6, 12, 24 and >24 months (R1) and 1 recurrence (7.7%) till month 24, and 3 (23.1%) thereafter (R2). BCVA increased from logarithm of the minimal angle of resolution 0.095 ± 0.141 (mean ± SD) at baseline to 0.066 ± 0.09 (group I), and from 0.090 ± 0.164 to 0.054 ± 0.124 (group II). Astigmatism decreased from -1.01 ± 0.90 dpt at baseline to -0.97 ± 1.24 dpt (group I), and from -1.19 ± 1.55 to -0.75 ± 0.87 dpt (group II). Conclusion: In comparison to CAG alone, additional excimer smoothing with PTK tends to increase BCVA and reduces recurrence rates in patients with primary pterygia.

Di Girolamo N, Chui J, Coroneo MT, et al: Pathogenesis of pterygia: role of cytokines, growth factors, and matrix metalloproteinases. Prog Retin Eye Res 2004;23:195-228.
Bradley JC, Yang W, Bradley RH, et al: The science of pterygia. Br J Ophthalmol 210; 94:815-820.
Sekundo W, Droutsas K, Cursiefen C: Operative Techniken bei chirurgischer Behandlung primärer und rezidivierender Pterygien. Ophthalmologe 2010;107:525-528.
Kaufman SC, Jacobs DS, Lee WB, et al: Options and adjuvants in surgery for pterygium. A report by the American Academy of Ophthalmology. Ophthalmology 2013;120:201-208.
Cardillo JA, Alves MR, Ambrosio LE, et al: Single intraoperative application versus postoperative mitomycin C eye drops in pterygium surgery. Ophthalmology 1995;102:1949-1952.
Chen PP, Ariyasu RG, Kaza V, et al: A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120:151-160.
Fakhry AM: The use of mitomycin C with autologous limbal-conjunctival autograft transplantation for management of recurrent pterygium. Clin Ophthalmol 2011;5:123-127.
Lewallen S: A randomized trial of conjunctival autografting for pterygium in the tropics. Ophthalmology 1989;96:1612-1614.
Singh G, Wilson MR, Foster CS: Mitomycin eye drops as treatment for pterygium. Ophthalmology 1988;95:813-821.
Kenyon KR, Wagoner MD, Hettinger ME: Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985;92:1461-1470.
Dadeya S, Malik KP, Gullian BP: Pterygium surgery: conjunctival rotation autograft versus conjunctival autograft. Ophthalmic Surg Lasers 2002;33:269-274.
Küçükerdönmez C, Akova YA, Altinörs DD: Comparison of conjunctival autograft with amniotic membrane transplantation for pterygium surgery: surgical and cosmetic outcome. Cornea 2007;26:407-413.
Tananuvat N, Martin T: The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft. Cornea 2004;23:458-463.
Liang WH, Li RR, Deng XY: Comparison of the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation. Yan Ke Xue Bao 2012;27:102-105.
Han SB, Hyon JY, Hwang JM, et al: Efficacy and safety of limbal-conjunctival autografting with limbal fixation sutures after pterygium excision. Ophthalmologica 2012;227:210-214.
Torres J, Fernández I, Quadrado MJ, et al: Estudio multicéntrico retrospectivo sobre trasplante de limbo. Arch Soc Esp Oftalmol 2008;83:417-422.
Kunitomo N, Mori S: Studies on pterygium. Report IV. A treatment of the pterygium by mitomycin C installation. Acta Soc Ophthalmol Jpn 1963;67:601-607.
Zaky KS, Khalifa YM: Efficacy of preoperative injection versus intraoperative application of mitomycin in recurrent pterygium surgery. Indian J Ophthalmol 2012;60:273-276.
Turan-Vural E, Torun-Acar B, Kivanc SA, et al: The effect of topical 0.05% cyclosporine on recurrence following pterygium surgery. Clin Ophthalmol 2011;5:881-885.
Viani GA, Fonseca EC, De Fendi LI, et al: Conjunctival autograft alone or combined with adjuvant beta-radiation? A randomized clinical trial. Int J Radiat Oncol Biol Phys 2012;82:e507-e511.
Viani GA, Stefano EJ, De Fendi LI, et al: Long-term results and prognostic factors of fractionated strontium-90 eye applicator for pterygium. Int J Radiat Oncol Biol Phys 2008;72:1174-1179.
Mourits MP, Wyrdeman HK, Jurgenliemk-Schulz IM, et al: Favorable long-term results of primary pterygium removal by bare sclera extirpation followed by a single 90strontium application. Eur J Ophthalmol 2008;18:327-331.
Por YM, Tan DT: Assessment of fibrin glue in pterygium surgery. Cornea 2010;29:1-4.
Jiang J, Yang Y, Zhang M, et al: Comparison of fibrin sealant and sutures for conjunctival autograft fixation in pterygium surgery: one-year follow-up. Ophthalmologica 2008;222:105-111.
Pan HW, Zhong JX, Jing CX: Comparison of fibrin glue versus suture for conjunctival autografting in pterygium surgery: a meta-analysis. Ophthalmology 2011;118:1049-1054.
Srinivasan S, Dollin M, McAllum P, et al: Fibrin glue versus sutures for attaching the conjunctival autograft in pterygium surgery: a prospective observed masked clinical trial. Br J Ophthalmol 2009;93:215-218.
Shenasi A, Mousavi F, Shoa-Ahari A, et al: Subconjunctival bevacizumab immediately after excision of primary pterygium: the first clinical trial. Cornea 2011;30:1219-1222.
Fallah MR, Khosravi K, Hashemian MN, et al: Efficacy of topical bevacizumab for inhibiting growth of impending recurrent pterygium. Curr Eye Res 2010;35:17-22.
Krag S, Ehlers N: Excimer laser treatment of pterygium. Acta Ophthalmol (Copenh) 1992;70:530-533.
Förster W, Atzler U, Ratkay I, et al: Excimerlaser-phototherapeutische Keratektomie (PTK) und modifizierte Bare-Sklera-Technik zur Behandlung von Pterygien. Ophthalmologe 1995;92:424-426.
Förster W, Atzler U, Ratkay I, et al: Therapeutic use of the 193-nm excimer laser in corneal pathologies. Graefe's Arch Clin Exp Ophthalmol 1997;235:296-305.
Talu H, Taşindi E, Ciftci F, et al: Excimer laser phototherapeutic keratectomy for recurrent pterygium. J Cataract Refract Surg 1998;24:1326-1332.
Walkow T, Anders N, Wollensak J: Kornealer Astigmatismus nach Pterygiumexzision und nachfolgender phototherapeutischer Keratektomie mit dem Excimerlaser (193 nm). Klin Monatsbl Augenheilkd 1996;209:199-204.
Walkow T, Anders N, Antoni HJ, et al: Die Rezidivhäufigkeit nach primärer Pterygiumexzision, phototherapeutischer Keratektomie (PTK) mit dem ArD:Excimerlaser und lokaler Mitomycin-C-Applikation. Klin Monatsbl Augenheilkd 1996;208:406-409.
Walkow T, Daniel J, Meyer CA, et al: Long-term results after bare sclera pterygium resection with excimer smoothing and local application of mitomycin C. Cornea 2005;24:378-381.
Jandrasits K, Schauersberger J, Nepp J, et al: Excimer-Laser versus Diamantschleifer: Gleichwertige Kurzzeitergebnisse bei Hornhautglättung nach Pterygiumoperationen. Klin Monatsbl Augenheilkd 2001;218:418-423.
Haider TA, Al-Amin LM, Bamashnus MA, et al: Ninety degree conjunctival rotation autograft versus zero and 180 degree rotation autograft for pterygium surgery. Saudi Med J 2009;30:519-523.
Müller S, Stahn J, Schmitz K, et al: Rezidivraten nach Pterygiumoperation mit Bindehautschwenklappen versus freies autologes Transplantat. Ophthalmologe 2007;104:480-483.
Rubinfeld RS: Letter to the editor: long-term results after bare sclera pterygium resection with excimer smoothing and local application of mitomycin C. Cornea 2006;25:758.
Sinha R, Sharma N, Vaipayee RB: Letter to the editor: long-term results after bare sclera pterygium resection with excimer smoothing and local application of mitomycin C. Cornea 2006;20:757.
Ang LP, Chua JL, Tan DT: Current concepts and techniques in pterygium treatment. Curr Opin Ophthalmol 2007;18:308-313.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.