Phototherapeutic keratectomy for treatment of recurrent pterygium

Abstract

Objective To evaluate the treatment outcomes of excimer laser phototherapeutic keratectomy (PTK) for recurrent pterygium.Methods 106 eyes of 106 patients diagnosed with recurrent pterygium that underwent PTK or autologous limbal stem cell transplantation were retrospectively evaluated.PTK treatment group (53 eyes):Pterygia were treated by separating and excising conjunctiva and pathological tissues.The residual pathological tissues underwent PTK with the Technolas 217z excimer laser.Control group (53 eyes):autologous limbal stem cell transplantation was performed.Data were analyzed for preoperative and postoperative reepitheliation,recurrence rate,and corneal astigmatism.Results The mean reepitheliation time of PTK group was (3.96 ± 0.78) days,and it was significantly shorter than that of control group (4.67 ± 1.01) days (t =-4.071,P ＜ 0.01).The mean postoperative corneal astigmatism in PTK group declined about (0.72 ± 0.80) D comparing to the preoperative one,and the improvement was signifi-cantly more than that of the control group (0.42 ± 0.43 D) (t =-1.342,P =0.02).The mean follow-up time was (18.05 ± 5.32) months.3 cases recurred in PTK group,the recurrence rate was 5.66％ ; 4 cases recurred in control group,the recurrence rate was 7.55％.There was no significant difference in recurrent rate between the two groups (x2 =0.368,P =0.70).Conclusion PTK can be a safe and effective therapeutic alternative for recurrent pterygium.It can avoid excessive operative trauma,hasten reepitheliation,and reduce corneal astigmastism.It can effectively decrease the recurrence rate of pterygium as autologous limbal stem cell transplantation. Key words: Keratectomy, phototherapeutic ; Pterygium; Stem cell, limbal