Purpose: Meta-analysis to compare pterygium surgery outcomes using limbal conjunctival autograft (LCAG) and other techniques.
Methods: A comprehensive literature search was conducted through June 2011 using PubMed, Embase, and the Cochrane Registry to identify all randomized control trials reported so far, comparing the recurrence rates of pterygium after LCAG and other surgical techniques. The odds ratios (ORs) and 95% confidence intervals (CIs) of rates of pterygium recurrence were pooled using the Mantel-Haenszel method.
Results: Overall, 13 randomized control trials were included in the analysis (Jadad score, 1-3). The pooled OR from individual studies showed that the recurrence rates after pterygium excision with LCAG were lower as compared with pterygium excision with bare sclera technique (95% CI, 0.04-0.17; pooled OR=0.08, P<0.01), bulbar conjunctival autograft (95% CI, 0.04-0.23; pooled OR=0.10, P<0.01), or intraoperative mitomycin C (95% CI, 0.09-0.52; pooled OR=0.22, P<0.01). There was no statistically significant difference in the recurrence rates after LCAG and amniotic membrane graft (95% CI, 0.26-1.70; pooled OR=0.66, P=0.39).
Conclusions: According to the current evidence from literature, recurrence rates after pterygium excision with LCAG are lower when compared with the use of bare sclera, bulbar conjunctival autograft, or intraoperative mitomycin C. Although recurrence rates of LCAG were similar to the amniotic membrane graft, further large-scale randomized controlled trials would be required to confirm these results.