Long-Term Surgical Outcome of Pterygium Excision and Conjunctival Limbal Autograft: Minimum 11 years Follow-up Study in a Country with High Ultraviolet Exposure

Hisham M Jammal,1 Rami Al-Omari,2 Zaki Shannak,3 Shadi Alkhatib,4 Hashem Abu Serhan3 1Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Ophthalmology, Faculty of Medicine, Yarmouk University, Irbid, Jordan; 3Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar; 4Alroya Eye Center, Irbid, JordanCorrespondence: Hisham M Jammal, Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan, Fax +962 2 7095123, Email [email protected]: To assess the long-term surgical outcome and complications in patients who underwent pterygium excision with conjunctival limbal autograft at least 11 years after surgery in a country with high ultraviolet light exposure.Material and Methods: This was a long-term, cross-sectional, observational follow-up study of 15 patients with primary or recurrent pterygium who underwent surgery at King Abdullah University Hospital, Jordan, between June 2005 and June 2012. Data regarding the patients’ satisfaction with the results, use of protective sunglasses, and daily sunlight exposure over the long-term period after surgery were collected. Recruited patients were then examined for pterygium recurrence and graft bed cosmesis. Primary outcome was the recurrence rate of pterygium. Secondary outcomes included graft bed appearance (cosmesis), patient-reported satisfaction, and long-term postoperative complications.Results: The mean (SD) age of the patients at the follow-up was 50 (8.8) years (range: 34– 66 years), and the mean (SD) follow-up duration was 13.1 (1.5) years (range: 11– 16 years). There was one case of recurrence (6.7%) and one case of symblepharon at the harvested graft site. Eleven out of the 15 patients reported being completely satisfied with the outcome of the surgery (mean score of 9.7 out of 10, SD: 1.0, range: 7– 10). Seven patients reported daily sunlight exposure of more than three hours, and most of them were not regular users of protective sunglasses.Conclusion: The long-term follow-up, pterygium excision with conjunctival limbal autograft was found to be safe and effective in a country with high ultraviolet exposure.Keywords: pterygium, conjunctival limbal autograft, recurrence, ultraviolet