Pterygium recurrence related to its size and corneal involvement

Objective: To establish the usefulness of grading system based on the size and extent of corneal involvement in predicting recurrence in patients undergoing primary pterygium excision with intraoperative use of adjunctive topical Mitomycin-C (MMC). Study Design: A case series. Place and Duration of Study: Section of Ophthalmology, the Aga Khan University Hospital, Karachi, from 2005 till 2010. Methodology: One hundred and twenty male patients (120 eyes) underwent surgical removal of pterygium using bare sclera method with MMC in concentration of 0.2 mg/ml (0.02%) with exposure time of 3 minutes. Classification of subjects was done according to the grading of pterygium. Patients were followed at 3 months interval for a minimum period of 1 year to record any recurrence. Results: The pterygium recurrence rate was 6.7% at a follow-up of 1 year. There was no significant association of pterygium recurrence with younger age (p = 0.14). A higher level of corneal involvement by the pterygium at presentation correlated significantly with the recurrence (p = 0.01). Conclusion: These results suggest that a higher grade of pterygium at presentation in patients leads to increased rate of recurrence after surgical excision. Hence, early excision of pterygium is recommended to decrease its recurrence rate.