Limbal-Conjunctival vs Conjunctival Autograft Transplant for Recurrent Pterygia A Prospective Randomized Controlled Trial

Objective: To compare the safety and efficacy of limbal-conjunctival vs conjunctival autograft transplant for treating recurrent pterygia. Methods: In a randomized, prospective, parallel-group clinical trial, 224 patients with advanced recurrent pterygia underwent free conjunctival autograft transplant (112 eyes) or limbal-conjunctival autograft transplant (112 eyes). Two hundred five patients completed the follow-up (100 eyes from the conjunctival autograft group and 105 eyes from the limbal-conjunctival autograft group). Main Outcome Measures: Recurrence of pterygium, with complications as the secondary outcome measure (ie, signs of limbal stem cell deficiency). Results: With a mean follow-up of 62 (range, 36-96) months, 10 patients (10.0%) in the conjunctival auto-graft group and 1 patient (1.0%) in the limbal-conjunctival autograft group developed recurrence. No signs of limbal stem cell deficiency were observed during follow-up. Conclusion: Limbal-conjunctival transplant is safe and more effective than free conjunctival transplant in preventing recurrence after excision of recurrent pterygia (P=.004). Application to Clinical Practice: Limbal-conjunctival autografts could be a favored option for managing advanced recurrent pterygia in young high-risk patients. JAMA Ophthalmol. 2013;131(1):11-16. Published online September 10, 2012. doi: 10.1001/archophthalmol.2012.2599