Pterygium shows ethnic differences

Key Points

"We are comfortable in concluding that this is the first case-controlled comparison of pterygium recurrence after any surgical modality in two ethnically different groups," said Dr. Chuck, the Paul Henkind Professor and chairman, Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY. "Hispanic ethnicity is a potential risk factor for recurrence of primary pterygia after conjunctival autograft (CAG), and it may be useful in preoperative counseling of our Hispanic candidates for primary pterygium excision. We need a prospective, randomized trial to delineate accurately the role of Hispanic ethnicity in pterygium recurrence."

Evaluating impact

The study population comprised Hispanic and Caucasian patients with primary nasal pterygia, 2 to 3.5 mm in from the limbus. Exclusion criteria included prior filtration surgery, corneal transplant, and a history of ocular trauma or chemical exposure, including ocular drops. In all, 26 eyes of 25 Hispanic (n = 14) and Caucasian (n = 11) patients, with a mean age of 52.8 years, were followed up for a mean of 10.8 months.

Preoperatively, all patients had pterygia of similar size and location. Patients were of similar age and sex and resided in southern California. All underwent the same intervention, postoperative care, and follow-up (mean, 9.3 months for the Hispanic group, 13 months for the Caucasian group).

"The follow-up time we believe was of an acceptable duration because 95% of recurrence occurs in the first year after surgery," Dr. Chuck said.

Surgical intervention consisted of pterygium excision with superior limbal CAG with postoperative topical steroids for 2 months.

"We use a lot of steroids typically for a long time in our pterygium patients," he said.

The primary outcome measure was pterygium recurrence, defined as any invasion of fibrovascular tissue past limbus onto clear cornea in the area of previous pterygium excision. Recurrence rates were significantly higher in the Hispanic population (40%) as compared with the Caucasian group (0%).

"This recurrence rate is consistent with the higher recurrence rates in Hispanics in other published studies," Dr. Chuck said.