A clinical study to evaluate recurrence of pterygium after primary surgery and its management

Abstract

Recurrence is a significant problem after pterygium excision. Therefore in this study its risk factors and management is discussed. This study was conducted to observe recurrence after conjunctival limbal autograft (CLAU) & to evaluate different factors related with recurrence of pterygium and assessing its different management methods. Hundred & seven patients with primary pterygium were examined, excised by CLAU and histopathology sample sent. The outcomes were assessed in terms of clinically significant recurrence till 6 months follow-up. Early topical mitomycin-C (MMC) 0.02% QID for a week was given to avoid resurgence of clinically significant pterygium, however if developed then excised by CLAU (if <4mm) or AMG (Amniotic membrane grafting) (if > 4mm). Out of total cases, 57% were females. Histopathology findings includeEpithelial Hyperplasia (80.4%), vascularity overwhelms fibrosis (39.1%), vascularity similar to fibrosis (28.3%), fibrosis overwhelms vascularity (34.8%), perivascular stromal inflammation (54.3%), diffuse stromal inflammation (37.0%). The following variables were significantly associated (p<0.05) with the recurrence: age, redness & thickness, higher vascularity, diffuse inflammation. Factors such as younger age group, higher redness and thickness of pterygium, more vascularity, and diffuse inflammation on histopathological examination can be considered as a risk factor for recurrence. However, occupation, location, and type of pterygium were found not to be related to recurrence. Although no clinically significant recurrence was seen after mitomycin c eyedrops, but no significant correlation can be made. Young patients having pre-operative features like red and fleshy pterygium, along with vascularity more than fibrosis and diffuse inflammation on histopathological examination should be followed strictly and managed intensely.