Treatment for pterygium using corneal limbal stem cell autograft combined with excision of pterygium under a microscope A contrast analysis in 198 patients of different races

Fasong XU; Yangfan YANG; Yanxia HU; Meihong ZHANG

ABSTRACT

BACKGROUND:

Therapeutic effect on pterygium mainly focuses on studying surgical technique, assistant therapy methods,and recurrence rate following excision of pterygium; however, whether race factor is associated with occurrence, development, and recurrence of pterygium remains still unknown.

OBJECTIVE:

To compare the therapeutic outcomes in different race patients with pterygium treated using corneal limbal stem cell autograft combining with excision of pterygium.DESIGN, TIME AND

SETTING:

Retrospective case analysis, performed in the Department of Ophthalmology, Zhongshan Hospital Affiliated to Xiamen University between January 2000 and June 2006.

PARTICIPANTS:

1 44 (152 eyes) primary cases were collected from Xiamen and 54 (54 eyes) relapsed Negroes were from Africa. There were no significant differences in age, sex, and pterygium length between the two groups (P 0.05).

METHODS:

198 subjects were treated by excision of pterygium under a microscope, in which pterygium tissue was not found on the surface of cornea. A free transplantation of the superotemporal limbus with an adjacent piece of thin conjunctiva was placed in the excision area. All cases were followed-up to grade the appearances of the sites 6 weeks, 6 and 12 months after excision (grade 1 implied normal appearance, and grade 4 implied the relapse). MAIN OUTCOME

MEASURES:

Relapse, pterygium grading, and complication after corneal limbal stem cell autograft combining with excision of pterygium.

RESULTS:

No relapse was found at 6 weeks after operation. The recurrence rate of Chinese Han people and Africa black people were 6.6% and 14.8% respectively at 6 months, and 11.8% and 24.5% at 12 months. There was significant difference in the recurrence rate between the two races (t=4.607, P= 0.032). In addition, there were significant differences in the pterygium grading between the two groups at 6 weeks (x2=15.608, P < 0.01 ), and Chinese people recovered better. Contrarily, there was no statistical difference at 6 months and 12 months (x2=4.401, 6.206; P 0.05). Few complications were found except superficial scar of cornea and persistent irritation of ocular surface.

CONCLUSION:

Limbal stem cell autograft combining with excision of pterygium under a microscope can completely remove pterygium with minimal invasion, light postoperative response and low rate of recurrence. The relapse of black cases is higher than Chinese patients.