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. 2000 Apr;84(4):385–389. doi: 10.1136/bjo.84.4.385

Analysis of variation in success rates in conjunctival autografting for primary and recurrent pterygium

S Ti 1, S Chee 1, K Dear 1, D Tan 1
PMCID: PMC1723439  PMID: 10729295

Abstract

AIMS—To evaluate the success rates of conjunctival autografting for primary and recurrent pterygium performed in a tertiary ophthalmic centre.
METHODS—The outcome of 139 cases with primary pterygia and 64 cases with recurrent pterygia who underwent excision with conjunctival autografting was retrospectively reviewed. Outcome was evaluated in terms of recurrence of pterygia onto the cornea. The recurrence rates were determined using Weibull survival functions, in a mixture model that included a component allowing for cure. The suitability of this model was verified using Turnbull's non-parametric method for interval censored data (1974). Estimated recurrence free probabilities were based on the fitted Weibull survival curves.
RESULTS—Mean follow up was 8.4 months in the primary group, and 9.5 months for the recurrent group. 29 out of 139 cases of primary pterygia recurred (20.8%) while 20 out of 64 cases in the recurrent group (31.2%) recurred. Recurrence rates varied widely among surgeons, ranging from 5% to 82%. Recurrence rates were inversely related to previous experience in performing conjunctival grafting. The recurrence free probability was 84% at 3 months, 73% at 1 year for primary pterygia, and 80% at 3 months, 67% at 1 year for recurrent pterygia. There was no statistical difference in recurrence rates between primary and recurrent groups (p= 0.80).
CONCLUSION—The success of conjunctival autografting for pterygium in this series varies widely, and may be related to a significant learning curve or differing surgical techniques for this procedure. This may account for the wide variation in reported success of this procedure in the ophthalmic literature.



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Figure 1  .

Figure 1  

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Ordinary lines show recurrence free survival for primary pterygium, bold lines for recurrent pterygium. The irregular lines are estimates derived using Turnbull's method, while the smooth curves are Weibull distributions fitted to the same data, incorporating a proportion of the patients who never have a recurrence.

Figure 2  .

Figure 2  

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Each curve is a Weibull distribution fitted to the recurrence free times of patients operated on by one surgeon. Only surgeons who contributed at least eight eyes to the data are included.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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