Risk Factors Involved in Pterygium Recurrence after Surgical Excision

Abstract

Purpose: To assess the influence of size and type of growth, age and gender of the patient and the duration of intraoperative mitomycin-C (MMC) application, on the recurrence of pterygium after surgical excision.
Material and Methods: This retrospective, descriptive case series was carried out at the department of ophthalmology, Aga Khan University Hospital, Karachi. One hundred forty seven patient’s (147 eyes) data files were analyzed from 1999 to 2009, who underwent surgical removal of pterygium using bare sclera method with MMC in concentration of 0.2 mg / ml (0.02%) with variable exposure time of 1-5 minutes. Ninety nine male and 48 female with mean age of 46.4 years (range 16 to 60 years) were included in the study. The classification of subjects was done according to the age, gender, MMC application time and type and size of pterygium. The main outcome measure was comparison of pterygium affected eye for any kind of recurrence after a minimum of 12 months of the follow up.
Results: The pterygium recurrence rate was 8.8% in our case series at the mean follow of 1 year. The factors such as younger age (< 50 years) at presentation (P = 0.04, Pearson chi square test) and the presence of secondary pterygium (P = 0.05) correlated significantly with the recurrence of pterygium. There was a definite trend of lesser recurrence seen with MMC application time of greater than 3 minute as well as for a lesser size of the pterygium. However, statistical significance could not be achieved because of the small sample size.
Conclusions: These results suggest that a younger age of < 50 years coupled with increased size as well as history of multiple recurrences and MMC application time of less than 3 minutes are risk factors for pterygium recurrence after surgical excision.