Efficacy with Autologous Conjunctival Implant Associated with Phototherapeutic Keratectomy (PTK) in the Treatment of the Pterygium

Abstract: Purpose: To evaluate the efficacy of new formula of the PTK calculated with the head-limbus-distance (=height) and limbal base length of the pterygium and ablation thickness on the anterior corneal curvature and visual acuity, associated with autologous conjuntival implant in patients with primary (Group A)and secondary(Group B) pterygium. Setting: This study was developed in the Department of Ophthalmology, Maggiore Hospital of Bologna. Design: Prospective non randomized study was conducted in 18 eyes of 18 subjects (9 eyes primary and 9 eyes with recurrent pterygium) operated with a dedicated PTK program. Methods: All patients signed informed consent before the start of the research. BCVA (Best Corrected Visual Acuity), mean refractive error (ME) and topographic astigmatism and recurrence of pterygium was followed. Mean follow up was 18.67 ± 6.13 months Min: 12 Max: 24 months. Results: Mean post-operative BCVA increased at 3-24 months compared with pre-op BCVA (p= 0.003). Mean post-op BCVA improved independent of the optical zone involvement in the pre-op (p= 0.845). Mean Pre-op astigmatism (Group A): was: 0,97 ± 2,7 (MIN: -2,8 Max: +5). Mean pre-op Astigmatism (Group B) :-0,33 ± 1,98 (MIN: -3 Max:+4). Astigmatism reduction in the group A: 0 D; Group B: -0,1D ± 0,74D MIN: -1 Max: +1. No statistically difference at 24 months from two groups in BCVA (p=0,59), Sf ( P=0,7), ME(p=0,7), astigmatism ( p=0,96) ANOVA. Recurrence of pterygium was: 0%. Conclusions: The dedicated programme of PTK was shown to be safe and effective for the treatment of the pterygium. BCVA can be improved by providing a smooth corneal surface in cases of optical zone involvement.