Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision.
OBJECTIVE
The purpose of the study is to determine whether amniotic membrane can be used as an alternative to conjunctival autograft after pterygium excision.


METHODS
A prospective study of amniotic membrane grafts (group A) and primary closure (group B) was compared retrospectively with conjunctival autografts (group C) in patients with pterygia.


METHODS
Group A included 46 eyes with primary pterygia and 8 eyes with recurrent pterygia, group B had 20 eyes with primary pterygia, and group C consisted of 78 eyes with primary and 44 eyes with recurrent pterygia.


METHODS
For the above three different surgeries, the amount of tissue removed was estimated from histopathologic analysis, and the result was evaluated by clinical examination.


METHODS
Recurrence, survival analysis, and final appearance were compared.


RESULTS
In group A, the recurrence rate was 10.9%, 37.5%, and 14.8% for primary, recurrent, and all pterygia, respectively (mean follow-up, 11 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 and B.


CONCLUSIONS
The relatively low recurrence rate for primary pterygia allows one to use amniotic membrane transplantation as an alternative first choice, especially for advanced cases with bilateral heads or those who might need glaucoma surgery later.
Prabhasawat
P
P
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Barton
K
K
Burkett
G
G
Tseng
S C
SC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011625:Pterygium / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D013536:Suture Techniques; D014182:Transplantation, Autologous