Outcomes of autoconjunctival grafting for primary pterygia when performed by consultant compared with trainee ophthalmologists

Abstract

To define rates of recurrence and surgical complications of primary pterygia excision with autoconjunctival grafting when the surgery is performed by consultant ophthalmologists compared with trainee ophthalmologists. A total of 174 patients with primary pterygia treated by excision and autoconjunctival grafting were included for analysis. Patients were divided into two groups according to whether their surgery was performed by a consultant ophthalmologist (group A) or a trainee ophthalmologist (group B). Data were collected with respect to demographics, surgical complications and recurrence. Recurrence rates were analysed utilizing Fisher's exact test. Additionally, Kaplan-Meier survival curves for interval censored data were constructed. Surgical complications were analysed utilizing Fisher's exact test. The recurrence rate in group A was 6.8% and in group B was 19.4%. This difference was statistically significant (P = 0.05). The rate of surgical complication occurring in group A was 6.6% and in group B was 23.3% and this was also statistically significant (P = 0.005). No relationship was found between either patient age or the size of pterygium and recurrence or complications in either group A or group B. Autoconjunctival grafting is regarded as the gold standard for preventing pterygium recurrence following excision. This study suggests that the experience of the surgeon can influence success rates and complications. There is a significant learning curve indicating the need to supervise trainee surgeons.