[Autologous conjunctiva-limbus transplantation in treatment of primary and recurrent pterygium].

The aim of the present study was evaluation of the efficiency of limbal autograft transplantation for primary and recurrent pterygia. The results of limbal autograft transplantation for advanced and recurrent pterygia are presented for 58 eyes of 50 patients. The pterygia were primary in 40 eyes and recurrent in 18 eyes. Free grafts from the superotemporal limbus of the same eye were used to cover the exposed sclera. Postoperative followup ranged from 2 to 26 months, with a mean of 13 months. The overall recurrence rate was 31% (22.5% in primary pterygia and 50% in recurrent pterygia). Recurrence rates were significantly higher in patients from southern Europe than in patients from northern Europe. Analysis of patients with recurrences (n = 18) revealed severe tear film abnormalities in eight cases. Seven patients were found to have transplants of insufficient size. Analysis of our results provides evidence that the experience of the surgeon is crucial for the success rate of this procedure. Three of six surgeons with limited experience had a recurrence rate of 50% or more. Additionally, 15 patients who developed recurrent pterygium had returned to unfavourable working conditions (e.g. dust, heat). Three of the 18 recurrences underwent repeated limbal transplantation and in one of these there was a further recurrence.