Postoperative treatment compliance rate and complications with two different protocols after pterygium excision and conjunctival autografting

Eur J Ophthalmol. 2021 May;31(3):932-937. doi: 10.1177/1120672120917335. Epub 2020 Apr 27.

Abstract

Aim: To evaluate compliance rate to pterygium postoperative treatment with two different protocols.

Methods: Review of clinical data of patients submitted to pterygium excision and conjunctival autografting in a single centre (and a single surgeon) in Barcelona between March 2014 and December 2017. Initial postoperative protocol (protocol 1) consisted of 4 months of topical steroids in a tapering fashion. Protocol 2 consisted of topical steroids tapered over 5 weeks. Compliance rate, complications and clinical outcomes were evaluated, and statistical comparisons were made.

Results: 120 surgeries were performed in 99 patients. Protocol 1 was applied in 63 cases and the next 57 followed protocol 2. Compliance with protocol 1 (57.6%) was lower than with protocol 2 (84.9%) (p = 0.002). Intraoperative complications (graft tear, corneal thinning, corneal perforation and bleeding) were found in 10 cases of protocol 1 and three cases of protocol 2, p = 0.08. Postoperative complications (graft dislocation, graft haematoma, ocular hypertension and recurrence) were found in 31 cases of protocol 1 (46.2%) and eight cases of protocol 2 (14%), p = 0.001. Six weeks after surgery, ocular hypertension was detected in eight cases corresponding to protocol 1 (13.6%) and two cases of protocol 2 (3.8%), p = 0.099. Recurrence rate during first year was higher in protocol 1 (26.3%) compared to protocol 2 (7.6%), p = 0.011. No cases of visual acuity worsening or infection were registered.

Conclusion: Protocol 2 has shown to have higher compliance rate than protocol 1 and less postoperative complications, proving to be a safe and effective postoperative treatment after pterygium surgery.

Keywords: Pterygium; conjunctival degenerations; cornea/external disease; diseases of the ocular surface; ocular surface surgery; pharmacology.

MeSH terms

  • Autografts
  • Conjunctiva
  • Follow-Up Studies
  • Humans
  • Patient Compliance
  • Postoperative Complications
  • Pterygium* / surgery
  • Recurrence
  • Transplantation, Autologous
  • Treatment Outcome