The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft

Abstract

A randomized, prospective study was performed to determine the efficacy and safety of amniotic membrane transplantation (AMT) vs conjunctival autograft (CAG) as adjunctive therapy after surgical excision of primary pterygium. Eighty-six eyes of 78 patients with pterygium that were either advancing more than 3 mm onto the cornea or causing extreme irritation were included in the study, randomized to either AMT (44 eyes of 39 patients) or CAG (42 eyes of 41 patients) as adjunctive therapy, and operated on by a single surgeon. The mean follow-up was 14.40 ± 5.4 months in the AMT group and 12.35 ± 3.13 months in the CAG group. There were 18 recurrences (40.9%) in the AMT group and 2 (4.8%) in the CAG group (P < .007). The cumulative proportion that were recurrence-free at 12 months was 0.6 ± 0.15 for the AMT group and 0.95 ± 0.07 for the CAG group (P = .0003, Log-rank test). The cumulative nonrecurrence rate at 6 and 12 months in all patients stratified by age and gender was not significantly different. No major complications were observed in either group. The authors conclude that amniotic membrane transplantation has an unacceptably high recurrence rate compared to conjunctival autograft transplantation as adjunctive therapy following excision of pterygium.—Michael D. Wagoner A randomized, prospective study was performed to determine the efficacy and safety of amniotic membrane transplantation (AMT) vs conjunctival autograft (CAG) as adjunctive therapy after surgical excision of primary pterygium. Eighty-six eyes of 78 patients with pterygium that were either advancing more than 3 mm onto the cornea or causing extreme irritation were included in the study, randomized to either AMT (44 eyes of 39 patients) or CAG (42 eyes of 41 patients) as adjunctive therapy, and operated on by a single surgeon. The mean follow-up was 14.40 ± 5.4 months in the AMT group and 12.35 ± 3.13 months in the CAG group. There were 18 recurrences (40.9%) in the AMT group and 2 (4.8%) in the CAG group (P < .007). The cumulative proportion that were recurrence-free at 12 months was 0.6 ± 0.15 for the AMT group and 0.95 ± 0.07 for the CAG group (P = .0003, Log-rank test). The cumulative nonrecurrence rate at 6 and 12 months in all patients stratified by age and gender was not significantly different. No major complications were observed in either group. The authors conclude that amniotic membrane transplantation has an unacceptably high recurrence rate compared to conjunctival autograft transplantation as adjunctive therapy following excision of pterygium.—Michael D. Wagoner