A randomized controlled trial comparing limbal-conjunctival autograft with conjunctival autograft in recurrent pterygium surgery with intraoperative application of 0.02% mitomycin C

To compare the outcomes of conjunctival graft (CAG) versus limbal-conjunctival autograft (LCAG) in preventing recurrence after surgery for recurrent pterygium with intraoperative application of 0.02% mitomycin C(MMC).

This prospective randomized controlled trial included one hundred thirty-two participants with recurrent pterygium who underwent either LCAG or CAG following pterygium excision, with intraoperative application of 0.02% MMC for 5 min (66 eyes in each group). Patients were followed for 12 months. The primary outcomes were recurrence and postoperative complications.

A total of 126 patients completed the 12-month follow-up, including 63 eyes in the LCAG group and 63 eyes in the CAG group. Recurrence occurred in 6 eyes (9.52%) in the LCAG group and 3 eyes (4.76%) in the CAG group. The absolute risk difference was − 4.76% (95% CI, − 13.1–3.6%), the relative risk was 0.50 (95% CI, 0.13–1.92), and the odds ratio was 0.48 (95% CI, 0.11–1.99), with no statistically significant difference between groups (χ² = 1.077, P = 0.299). No significant association was found between recurrence and surgical method, age, sex, number of previous excisions, size of pterygium or autograft, or degree of vascularization. Localized donor-site pannus formation was observed in 19 eyes (30.16%) in the LCAG group. No scleral or corneal melting was observed during follow-up. Limbal stem cell function was not objectively assessed.

In this prospective randomized superiority trial,no statistically significant difference was detected in recurrence rates of recurrent pterygium after surgery with mitomycin C application between the LCAG and CAG groups during the 12-month follow-up period. Localized donor-site pannus formation was seen in some eyes with LCAG.