Efficacy of treatment for pterygium by autologous conjunctival transplantation and mitomycin C

Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation （ACT） versus mitomycin C （MMC）. Methods Relevant literature published until December 2010 in Medline, Embase, Cochrane, Cochrane library, Science Citation Index, and Google Scholar were searched. Qualified random clinical trial （RCT） studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study. Results Eight RCTs with 663 eyes entered the final analysis. The recurrent rate of pterygium was 8.7% （30/343） for ACT and 18.75% （60/320） for MMC. Using fixed-effect meta analysis, we found that the recurrence was significantly lower after ACT than MMC treatment （odds ratio （OR）=0.40, 95% confidence index （C/）, 0.25-0.63, P 〈0.0001）. In sensitivity analyses, we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation. All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC. Sub-group analysis revealed that the recurrence rate was 20.2% （20/99） and 27.65% （26/94） for conjunctival autograft （CA） and MMC respectively, and no significant difference in the recurrence rate was detected （OR=0.65, 95% CI 0.33-1.28, P=0.22）. However, we found that conjunctival limbal autograft （CLA） had lower recurrence rate than MMC （OR=0.26, 95% CI 0.14-0.48, P=0.0001）.

Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.