Impact of Pterygium Excision Combined with Autologous Limbal Stem Cell Transplantation on Microvascular Density, Tear Film Stability, and Corneal Wound Healing.

Aim: This study aimed to evaluate the impact of pterygium excision combined with autologous limbal stem cell transplantation on microvascular density, tear film stability, and corneal wound healing in the management of pterygium.

Methods: A retrospective analysis was conducted on 317 patients with pterygium who underwent treatment between January 2021 and January 2024. Patients were divided into a control group (pterygium excision alone, n = 161) and a study group (pterygium excision combined with autologous limbal stem cell transplantation, n = 156) based on the surgical approach. The study compared the surgical efficacy, perioperative outcomes, and corneal healing between the two groups. Preoperative and postoperative changes in conjunctival microvascular density, tear film stability indicators, and ocular comfort scores were also assessed.

Results: The effective treatment rate was significantly higher in the study group compared to the control group (p < 0.05). Postoperative uncorrected visual acuity, vertical corneal curvature, and horizontal corneal curvature were significantly better in the study group, whereas corneal astigmatism was lower than in the control group (p < 0.05). The postoperative levels of pigment epithelial derived factor (PEDF) were higher in the study group, while levels of vascular endothelial growth factor (VEGF) and microvascular density (MVD) were lower than in the control group (p < 0.05). Corneal healing scores on postoperative days 1, 3, and 7 were lower in the study group than in the control group, and the time resolution of corneal wound congestion and corneal epithelial coverage was significantly shorter compared to the control group (p < 0.05). Tear film stability, as indicated by the Schirmer I test (SIt) and tear breakup time (BUT), was improved in the study group than that in the control group (p < 0.05). Postoperative ocular comfort scores were lower in the study group compared to the control group (p < 0.05). No significant difference in postoperative complication rates was observed between the groups (p > 0.05).

Conclusions: Pterygium excision combined with autologous limbal stem cell transplantation effectively inhibits angiogenesis, improves visual function, enhances tear film stability, and accelerates corneal wound healing, making it a superior treatment option for pterygium.