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Efficacy of treatment for pterygium by autologous conjunctival transplantation and mitomycin C

摘要Background The recurrence of pterygium after surgery is high.A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published.This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation (ACT)versus mitomycin C (MMC).Methods Relevant literature published until December 2010 in Medline,Embase,Cochrane,Cochrane library,Science Citation Index,and Google Scholar were searched.Qualified random clinical trial (RCT) studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study.Results Eight RCTs with 663 eyes entered the final analysis.The recurrent rate of pterygium was 8.7% (30/343) for ACT and 18.75% (60/320) for MMC.Using fixed-effect meta analysis,we found that the recurrence was significantly lower after ACT than MMC treatment (odds ratio (OR)=0.40,95% confidence index (CI),0.25-0.63,P <0.0001).In sensitivity analyses,we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation.All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC.Sub-group analysis revealed that the recurrence rate was 20.2% (20/99) and 27.65% (26/94) for conjunctival autograft (CA) and MMC respectively,and no significant difference in the recurrence rate was detected (OR=0.65,95%CI 0.33-1.28,P=0.22).However,we found that conjunctival limbal autograft (CLA) had lower recurrence rate than MMC (OR=0.26,95% CI 0.14-0.48,P=0.0001).Conclusion CLA has better therapy efficacy against the recurrence of pterygium than MMC.

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作者单位 Department of Ophthalmology, First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China [1] Department of Ophthalmology, Putuo Hospital, Affiliated Shanghai Traditional Medicine University, Shanghai 200062,China [2]
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DOI 10.3760/cma.j.issn.0366-6999.2012.20.024
发布时间 2013-01-21
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中华医学杂志(英文版)

中华医学杂志(英文版)

2012年125卷20期

3730-3734页

SCIMEDLINEISTICCSCDCABP

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