Comparison of conjunctival autograft with amniotic membrane transplantation for pterygium surgery: surgical and cosmetic outcome.

Purpose: To compare the clinical results of conjunctival autograft and amniotic membrane transplantation (AMT) for primary and recurrent pterygium excision. In an effort to determine whether AMT yields acceptable cosmetic results as conjunctival autografting in pterygium surgery, we compared the final cosmetic outcomes of these 2 techniques.

Methods: We performed a prospective, randomized clinical study of 78 eyes (78 patients) divided into 2 groups. Forty eyes (28 with primary and 12 with recurrent pterygia) received conjunctival limbal autograft (group 1), and 38 eyes (27 with primary and 11 with recurrent pterygia) received AMT (group 2) after extensive removal of pterygium. Mean follow-up time was 16.6 +/- 3.52 months in group 1 and 13.4 +/- 2.08 months in group 2. The results were evaluated by clinical examination and photographing and final appearances were graded from 1 to 4. Grade 4 represented true recurrence, whereas grade 3 indicated unacceptable cosmetic appearance.

Results: Recurrence rates of primary, recurrent, and all pterygia in group 1 and group 2 were 3.6%, 16.7%, and 7.5% and 3.7%, 18.2%, and 7.9%, respectively. There was no significant difference in recurrence rates between the 2 groups (P = 1.00 for all). The rates of final appearance as grade 3 were 10.0% in group 1 and 21.1% in group 2, and the difference was statistically significant (P = 0.048). No major complications occurred during the follow-up period.

Conclusions: Although better results in the final appearance were achieved using conjunctival autografting than with AMT, AMT can be a useful alternative in pterygium surgery, especially in those patients who may have a limited amount of conjunctiva for future surgeries.