Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis

Abstract

Conjunctival autograft transplantation (CAT) and amniotic membrane transplantation (AMT) are two widely used techniques for pterygium treatment. However, previous studies comparing the outcomes of CAT and AMT have generally had small sample sizes and conflicting results. The aim of this report was to evaluate and comment on peer-reviewed literature for evidence of effectiveness and safety of CAT and AMT for management of pterygium. Studies comparing outcomes of CAT and AMT for pterygium treatment were identified by searching PubMed, Embase, Web of Knowledge, and a search of all references in relevant papers. Two reviewers confirmed study eligibility and extracted data independently, and data were pooled using standard meta-analysis techniques. Five eligible studies reporting outcomes in 538 eyes were included. The pooled hazard ratio (HR) estimate for recurrence of CAT compared to AMT was 0.30 (95% confidence interval (CI) [0.16, 0.59], p < 0.001) and 0.22 (95%CI [0.02, 2.37], p = 0.214), respectively, for primary and recurrent pterygium. For unacceptable appearance, the pooled HR estimate was 0.33 (95% CI [0.16, 0.66], p = 0.002). There were no statistically significant differences in adverse events (odds ratio (OR) = 0.96, 95% CI [0.46, 1.97], p = 0.901). Available trials indicate that CAT has lower recurrence risk compared to AMT for primary pterygium treatment, as well as lower risk of unacceptable appearance risk.