Comparing treatment options of pterygium: limbal sliding flap transplantation, primary closing, and amniotic membrane grafting

Abstract

Purpose: To compare 3 surgical treatment options of pterygium: limbal sliding flap transplantation, primary closing, and amniotic membrane grafting methods. Methods: Seventy-five patients with primary pterygium were included in the study. Snellen visual acuity measurement, grading pterygium, slit-lamp examination, keratometry and anterior segment photography were performed preoperatively. Twenty-eight eyes of 28 patients (group 1) underwent limbal-conjunctival sliding flap transplantation, 22 eyes of 22 patients (group 2) underwent amniotic membrane grafting, and 25 eyes of 25 patients (group 3) underwent primary closing surgery The patients were followed up on the first day and the first week after surgery and then at months 1, 3, 6, and 12. Results: The mean size of the pterygium preoperatively was 3.58 +/- 1.1 mm in group 1, 3.95 +/- 0.90 mm in group 2, and 3.5 +/- 0.87 mm in group 3. The mean follow-up time was 15.07 +/- 13.8 months in group 1, 20.2 +/- 6.7 months in group 2, and 28.04 +/- 9.9 months in group 3. Grade 4 corneal recurrence rate in follow-up was 7.1% in group 1, 27.3% in group 2, and 56% in group 3 (p = 0,00). Mean recurrence times were 4.0 +/- 1,7, 4.4 +/- 3.3, and 4.4 +/- 3.6 months according to groups 1, 2, and 3 (p = 0.963). After the surgery, corneal astigmatism decreased and keratometric values increased significantly in all the groups with no statistically significant difference between the groups (p>0.05). Conclusions: Limbal-conjunctival sliding flap transplantation is an efficient method to manage primary pterygium. It may be a safe and effective initial treatment option to reduce risk of recurrence and postoperative complications of pterygium surgery.