Effectiveness of conjunctival-limbal autograft with marginal Tenon’s layer excision in pterygium treatment: non-randomized comparative study

Abstract Purpose: To unveil the success rate of conjunctival-limbal autograft with marginal Tenon’s layer excision (CLAG-MTE) on pterygium recurrence rate. Materials and Methods: This study is an interventional non-randomized, non-equivalent control group design. Data of 40 patients in CLAG group and 38 patients in CLAG-MTE group retrospectively reviewed. Patients of the both series were selected from whose surgeries were performed from February 2008 to January 2015. The recurrence rate of conjunctival-limbal autograft (CLAG) and CLAG-MTE was compared. And also, the limbal-conjunctival series of some studies which reported a high success rate on recurrence rate and Hirst's preliminary series were included in this comparison. Results: The recurrence rate was 5.1% (4 eyes) in the CLAG group and 0% in the CLAG-MTE group. The mean follow-up period was 21.1±5.6 months in the CLAG group and 22.6±6.8 in the CLAG-MTE group. In Fisher's Exact Test, the difference in recurrence rate between the CLAG and the CLAG-MTE groups was not statistically significant. When all the series were compared by One-way ANOVA in respect to recurrence rate, significant differences were found between a number of them. CLAG series, still, were found successful like CLAG-MTE series. However, when they were compared with Hirst’s and Al Fayez’s series, CLAG-MTE series were found to be more successful than CLAG series. Also, in the means of plot analysis, the CLAG-MTE series were showing the lowest plot while the CLAG and Güler’s series were showing the highest plot. The other series -especially the Hirst’s- ranked in between. Conclusions: CLAG-MTE is the most effective in preventing recurrence among the techniques which were compared in this study. Moreover, it is relatively easy and less invasive in comparison to Hirst's technique. Synopsis The CLAG-MTE is a successful technique. Besides, Tenon’s capsule pulleys are not touched and it is done far from semilunar fold. So, the surgery involves only the ocular surface.