Observation of long-term efficacy of corneal limbal conjunctival autografts in microscopy treatments of pterygium.

PURPOSE: To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium. METHODS: This random control study included 63 patients (63 eyes) with primary pterygium. These were randomly divided into a group with corneal limbal conjunctival autograft combined with pterygium excision (group A) and a group with pterygium excision with exposed sclera (group B) and subjected to long-term follow up. The surgical outcomes were classified and evaluated (grade I-IV). Several indexes were analyzed, including ocular surface irritation symptom, tear film stability, surgical complication, and recurrence rate. RESULTS: The follow up ranged from 24 to 38 months, (26.9+/-3.4) months on average. No recurrence was noted at 6 weeks postoperatively. At 6 months postoperatively, the recurrence rate of pterygium was 5.2% in group A and 8.0% in group B. At 1 year postoperatively, the recurrence rate in group A was 10.5% and 20.0% in group B. At the end of follow up, the recurrence rates were 13.1% in group A and 24.0% in group B. No statistical significance was found between two groups regarding the recurrence rates at each time point (P>0.05). After the follow up (> 2 years), the severity of ocular surface conditions was significantly milder in patients in group A than in group B (P<0.01). No statistically significant differences were noted between the two groups at 6 weeks, 6 months, and 1 year after surgery. No statistically significant differences were observed between the two groups regarding postoperative tear film break-up time. Fewer postoperative complications and milder ocular surface irritation symptoms occurred in patients in group A. CONCLUSION: Corneal limbal conjunctival autograft combined with pterygium excision yields sound long-term efficacy and a low recurrence rate and induces only mild damage on the ocular surface when used as a treatment for pterygium.

Long-term outcomes of domestic hunan aqueous drainage implantation in refractory glaucoma.

PURPOSE: To evaluate the long-term outcomes of a non-valved, Chinese-made Hunan aqueous drainage device (HAD) in patients with refractory glaucoma, compared to trabeculectomy. METHODS: This was a retrospective observational case series, including 27 patients with refractory glaucoma who either underwent HAD implantation (n=11) or trabeculectomy (n=16). The mean follow-up was 27.9±13.5 (mean±SD) months. Intraocular pressure (IOP), visual acuity and postoperative complications were measured. RESULTS: IOP was significantly lower at the last follow-up in both two groups compared with the baseline IOP (HAD: 58.4 to 10.0 mmHg, P>0.001; trabeculectomy:58.4 to 23.7 mmHg, P<0.001). One week, 1 month and 1 year after the operation, the average IOP of the HAD group was significantly lower than that of trabeculectomy group (P<0.05 at all time points). However, , the IOP did not differ significantly between the two groups at the time of last follow-up. CONCLUSION: HAD implantation serves as a good option to control IOP in refractory glaucoma.