Primary Pterygium Excision Surgery: Analysis Of Risk Factors And Clinical Outcomes Over 5 Year Follow-Up

To evaluate clinical outcomes of primary pterygium excision surgery and analyse risk factors for pterygium recurrence to enable us to improve management and minimise recurrence

Department of Cornea and External Diseases, Whipps Cross Hospital, London, United Kingdom

Retrospective case series of eyes undergoing primary pterygium excision between August 2017 and July 2022. Patients who had “pterygium excision” operation documented in their electronic medical records were identified. Patients who underwent surgery for a recurrent pterygium and those lost to follow-up were excluded. The duration of follow-up, type of surgery performed (primary conjunctival closure, conjunctival autograft and amniotic membrane transplantation), recurrences with respect to the type of surgery performed and postoperative complications were collected and analysed.

65 eyes (from 65 patients) were included. The mean age of our patient cohort was 57.9 years. The most common ethnic distribution was Black African (29.2%). 72% of surgeries was performed by a consultant surgeon, with the remainder being performed by supervised junior doctors in ophthalmology training. Conjunctival autograft (CAG) was performed in 62 of 65 eyes (95%), primary conjunctival closure was performed in 2 of 65 eyes (3%) and amniotic membrane graft was performed in 1 of 65 eyes (2%). The recurrence rate for eyes in which CAG was performed was 6.4% compared to a 100% recurrence rate in eyes in which CAG was not performed (p<0.0001). Recurrence rate was significantly higher in patients below 45 years of age (18 vs 6%, p<0.001).

Our findings demonstrate the effectiveness of CAG for the surgical management of primary pterygium. Recurrence rate was highest in patients below the age of 45 years old whilst there was no difference in recurrence rate between cases operated on by a consultant and cases operated on by a supervised junior surgeon.