Risk Factors for Recurrence After Pterygium Surgery: An Image Analysis Study.
OBJECTIVE
To determine the risk factors related to recurrence of pterygium using automated image analysis.


METHODS
This study included 149 eyes of 149 patients who underwent pterygium excision and limbal-conjunctival autograft. Demographic variables including age and sex were collected. Image analysis was performed using anterior segment photographs taken preoperatively to measure relative length (horizontal length of pterygium invading cornea/horizontal corneal diameter), relative width (width of pterygium invading cornea/vertical corneal diameter), relative area (RA; area of pterygium invading cornea/total corneal area), and vascularity index (VI; degree of vascularity). In all patients, recurrence of pterygium was determined at 1 year after surgery. Association between these factors and recurrence rate was evaluated with univariate and multivariate analyses.


RESULTS
Recurrence at 1 year was reported in 18.8% (28/149) of the patients. Univariate analysis showed that relative length (P = 0.001), relative width (P = 0.031), relative area (P = 0.009), and VI (P < 0.001) were significantly associated with increased risk of recurrence, whereas age and sex had no significant association with recurrence. In multivariate analysis, only VI (P < 0.001) had significant correlation with recurrence. Patients with VI ≥30 had significantly higher recurrence rate than those with VI <30 (33.3% vs. 8.1%, P < 0.001).


CONCLUSIONS
Increased vascularity was associated with a higher risk of recurrence. Quantification of vascularity using automated image analysis might be useful in predicting the risk of recurrence.
*Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Korea; †Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea; ‡Biomedical Engineering Branch, Division of Convergence Technology, National Cancer Center, Goyang, Korea; and §Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Sang Beom
SB
Han
Hyun Sun
HS
Jeon
Moosang
M
Kim
Seung-Jun
SJ
Lee
Hee Kyung
HK
Yang
Jeong-Min
JM
Hwang
Kwang Gi
KG
Kim
Joon Young
JY
Hyon
Won Ryang
WR
Wee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064592:Autografts; D003228:Conjunctiva / Q000098:blood supply / Q000637:transplantation; D005260:Female; D006801:Humans; D016850:Limbus Corneae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology; D013508:Ophthalmologic Surgical Procedures; D010781:Photography; D011625:Pterygium / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors