Risk Factors for Recurrence in the Treatment of Recurrent Pterygium

Kusano, Yuki MD*,†; Den, Seika MD, PhD‡; Yamaguchi, Takefumi MD*; Nishisako, Sota MS§; Fukui, Masaki MD, PhD*; Shimazaki, Jun MD, PhD*,§

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Cornea ():10.1097/ICO.0000000000003422, November 9, 2023. | DOI: 10.1097/ICO.0000000000003422

The aim of this study was to identify the postoperative recurrence rate of recurrent pterygium and to evaluate risk factors for the recurrence.

This study was a retrospective interventional nonrandomized consecutive case series. In this single-center study, 119 eyes of patients with recurrent pterygium who underwent surgery with a follow-up period of >12 months after the surgery were analyzed. The clinical characteristics of pterygium were classified according to the length of corneal involvement and Tan grade. The main outcome was the recurrence rate. The secondary outcome was the risk factors for recurrence.

The mean follow-up period was 42 ± 28.6 months. Recurrence was observed in 15 patients (12.6%). The average postoperative recurrence period was 7.7 ± 6.7 months. Twelve patients experienced a recurrence within 12 months. Eyes with recurrence had a significantly greater length of corneal involvement (2.47 ± 0.72 mm) and number of previous surgery (1.9 ± 1.3) than those without (1.97 ± 0.74 mm, and 1.3 ± 0.7, both P = 0.04). Multivariate analysis showed that recurrence was significantly associated with the length of corneal involvement (odds ratio [OR] 2.38, 95% confidence interval [CI], 1.02–5.57, P = 0.05) and the number of previous surgeries (OR: 1.91, 95% CI, 1.03–3.58, P = 0.04) but not with sex (OR: 3.71, 95% CI, 0.90–15.2, P = 0.07), age (OR: 0.99, 95% CI, 0.94–1.04, P = 0.59), and use of mitomycin C (OR: 0.31, 95% CI, 0.07–1.21, P = 0.09).

The postoperative recurrence rate of recurrent pterygium was 12.6%. The preoperative length of corneal involvement and number of previous pterygium surgeries were significantly correlated with recurrence. Male sex and nonuse of mitomycin C tended to correlate with recurrence.