Pterygium
Last updated: April 16th, 2022
Summary of Evidence
Surgical technique
Conjunctival autograft vs amniotic membrane transplantation
Analysis of 20 studies involving 1947 eyes of 1866 patients concluded that in association with pterygium excision, conjunctival autograft is associated with a lower risk of recurrence at six months’ after surgery than amniotic membrane transplant, especially in patients with recurrent pterygia. {Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016 Feb 11;2:CD011349.}
Fibrin glue vs sutures
Analysis of 14 RCTs showed fibrin glue may result in less recurrence (risk ratio 0.47) and may take less time than sutures for fixing the conjunctival graft in place during pterygium surgery, but may result in more complications (risk ratio 1.92) such as graft dehiscence, graft retraction and granuloma. {Romano V, Cruciani M, Conti L, Fontana L. Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery. Cochrane Database Syst Rev. 2016 Dec 2;12(12):CD011308.}
Adjuvant Cyclosporine A
Meta-analysis of 7 studies showed that adjuvant use of Cyclosporine A (CsA) can significantly reduce the risk of pterygium recurrence compared with pterygium excision alone, whereas adjuvant use of CsA may not reduce the risk of pterygium recurrence in pterygium excision + limbal conjunctival autograft or conjunctival flap rotation. {Zhang Q, Bao N, Liang K, Tao L. Adjuvant Use of Cyclosporine A in the Treatment of Primary Pterygium: A Systematic Review and Meta-Analysis. Cornea. 2018 Aug;37(8):1000-1007.}