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More pterygium recurrence with amniotic membrane than conjunctival autograft in study
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More recurrence was seen with amniotic membrane graft than with conjunctival autograft after pterygium excision, a randomized study found. However, amniotic membrane may still be a first-choice option for certain patients, such as those who may need glaucoma surgery later or those with diffuse conjunctival involvement, the study authors said.
Patanaree Luanratanakorn, MD, of Khon Kean University, Thailand, and colleagues compared the efficacy of the two types of graft in a prospective study of 287 Asian patients undergoing surgical excision of pterygium. The researchers randomly assigned 120 eyes of 120 patients to undergo conjunctival autograft and 167 eyes of 167 patients to receive amniotic membrane grafting.
In the conjunctival autograft group, 106 eyes had primary pterygium and 14 had recurrent pterygium. In the amniotic membrane group, 148 eyes had primary pterygium and 19 had recurrent pterygium.
The researchers found a statistically significantly lower rate of pterygium recurrence among eyes treated with conjunctival autograft (P=.003).
At 6 months' follow-up, 13.3% of eyes with primary pterygium and 21.4% of eyes with recurrent pterygium in the conjunctival autograft group experienced recurrence. Among eyes treated with amniotic membrane, 25% of eyes with primary pterygium and 52.6% of eyes with recurrent pterygium experienced recurrence, according to the study.
"Although this study shows that amniotic membrane grafts are less proficient than conjunctival autografts in reducing recurrences after pterygium excision, it indicates that this technique could be considered as an alternative in the surgical management of pterygia, especially when the bare sclera technique alone has an unacceptably high recurrence, and complications related to mitomycin-C as an adjunctive treatment are a concern," the study authors said.
Aminotic membrane graft can be considered as a first choice for patients "with advanced and diffuse conjunctival involvement (bi-head) or those who might like to preserve the donor bulbar conjunctiva for a prospective glaucoma-filtering procedure," they said.
The study is published in the December issue of the British Journal of Ophthalmology.