Observation on the Efficacy of Limbal Stem Cell Transplantation Combined with Pterygium Excision for the Treatment of Pterygium

Abstract Objective Pterygium, as a common ocular surface proliferative disease, is a complex pathological process involving multiple factors and links. Its occurrence and development are primarily attributed to various theoretical hypotheses, including long-term ultraviolet exposure, chronic inflammatory stimulation, tear dynamics abnormalities, and limbal stem cell dysfunction. Among these, the disruption and functional failure of the limbal stem cell microenvironment are considered the core factors leading to disease progression and postoperative recurrence. The limbus, as a crucial anatomical barrier between the cornea and conjunctiva, not only is responsible for the daily renewal and wound repair of the corneal epithelium but also inhibits abnormal invasion of conjunctival blood vessels and fibrous tissue by maintaining the balance of local cytokine networks. When various pathogenic factors reduce the number or impair the function of stem cells in this region, this barrier effect weakens or even disappears, thereby creating conditions for the formation and development of pterygium. Although traditional simple pterygium excision can effectively remove visible proliferative tissue, the surgery itself further damages the already fragile limbal structure, causing more extensive stem cell loss. This iatrogenic injury may lead to delayed corneal epithelial repair, abnormal conjunctival epithelial migration, or even more severe tissue regeneration disorders postoperatively. Ultimately, this manifests as a persistently high recurrence rate, ranging from 20% to 40%. Purpose Consequently, effectively reconstructing the anatomical structure and functional integrity of the limbus has become a critical factor for successful treatment. In recent years, with the continuous advancement of tissue engineering technology and the concept of ocular surface reconstruction, limbal stem cell transplantation has been increasingly applied in the surgical treatment of pterygium. Its core mechanism lies in transplanting healthy autologous limbal stem cells to restore the function of the stem cell pool in the damaged area, thereby reconstructing the physical and biological barrier between the cornea and conjunctiva. The transplanted stem cells not only directly proliferate and differentiate into transparent corneal epithelial cells to accelerate wound healing but also, through paracrine effects, release various growth factors and extracellular matrix components, such as epidermal growth factor, transforming growth factor-β, and fibronectin. These bioactive substances can regulate the local microenvironment, inhibit excessive proliferation of fibroblasts and neovascularization, thereby fundamentally blocking the pathological pathway of pterygium recurrence. This study evaluated the clinical efficacy and safety of limbal stem cell transplantation combined with pterygium excision for the treatment of pterygium. Methods A total of 106 patients with pterygium admitted from April 2023 to May 2025 were randomly divided into a control group and an experimental group, with 53 patients in each group. The control group underwent simple pterygium excision, while the experimental group underwent pterygium excision combined with limbal stem cell transplantation. The postoperative corneal epithelial repair time, recurrence rate, and visual quality improvement were compared between the two groups. Results The corneal epithelial repair time in the experimental group was significantly shorter than that in the control group, the recurrence rate at 6 months postoperatively was significantly lower, and the degree of visual quality improvement was superior to that in the control group, with statistically significant differences (P<0.05). Conclusion Limbal stem cell transplantation combined with pterygium excision can effectively promote corneal repair, reduce the recurrence rate, and improve visual quality, making it a safe and effective treatment method.