Risk factors for pterygium recurrence after limbal-conjunctival autografting: a retrospective, single-centre investigation

Purpose: To determine the risk factors related to recurrence of pterygium after pterygium excision with limbal-conjunctival autograft. Study design: Retrospective, observational case series. Methods: The current study included 310 patients who underwent surgical removal of pterygium using limbal-conjunctival autografting. All surgery was performed by the same surgeon at a single Hospital from 2006 to 2011. Preoperative and postoperative patient data were collected. The patients were summoned to follow-up examinations. Procedures with at least 12 months of follow-up were included in the final analysis. Potential risk factors for pterygium recurrence were determined by Cox proportional-hazard linear analysis and recurrence-free survival time was evaluated using Kaplan–Meier method. Results: The overall recurrence rate was 5.2% during an average follow-up time of 20.1±8.6 months (range, 12–37 months). According to Kaplan–Meier evaluation, the estimated time to recurrence was 34.2 ± 0.5 months (95% confidence interval 33.3–35.0 months) for the whole population. Multivariate analysis showed that age < 45 years old (RR = 3.582, 95% CI 1.984–13.044, P = 0.047), recurrent type of pterygia (RR = 4.856, 95% CI 1.794–13.142, P = 0.002), and vertical size of pterygium > 6.7 mm (RR = 2.529, 95% CI 1.053–6.075, P = 0.038) were significantly associated with increased risk of recurrence. Conclusion: Our findings suggest that young age, recurrent type of pterygia, and larger pterygial tissue are risk factors for pterygium recurrence after surgical excision. Hence, early excision of pterygium is recommended to decrease the recurrence rate.