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Surgeons debate conjunctival autograft, amniotic membrane for pterygium
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CHICAGO — While one speaker here said that conjunctival autograft remains the gold standard treatment in pterygium surgery, another surgeon posited the superior efficacy of amniotic membrane.
Allan R. Slomovic, MD, and John A. Hovanesian, MD, took part in a “battle of the experts” during Corneal Subspecialty Day preceding the American Society of Cataract and Refractive Surgery meeting.
“Evidence-based studies have shown that conjunctival autograft provides significantly lower recurrence rates, significantly better cosmetic results, has a great safety track record and is significantly more cost-effective,” Dr. Slomovic said.
Amniotic membrane costs $475 to $835, while conjunctival autograft has no monetary cost, Dr. Slomovic noted. Additionally, conjunctival autograft tissue is self-replenishing within 4 to 6 months, he said.
However, not all patients have sufficient conjunctival tissue to render viable autografts, according to Dr. Hovanesian. Subconjunctival amniotic membrane with autograft has a pterygium recurrence rate of 10%, while the recurrence rate for autograft alone is 50%, he said.
Amniotic membrane is free in Canada but not in the U.S., Dr. Hovanesian said.
“But, indeed, the cost is something that you have to factor in,” he said. “Frankly, decide for each patient which is appropriate.”
- Disclosure: Dr. Hovanesian has financial relationships with Calhoun Vision and IOP. Dr. Slomovic has no relevant financial disclosures.