Transcript Longest follow-up was 3949 days (130 months).

Survival-Rate Statistics For
Excision of Pterygium and
Conjunctival Autograft Surgery
David Varssano MD, Hadas Shalev B.Med.Sci,
Naomi Fischer MD, Moshe Lazar MD
Department of Ophthalmology, Tel Aviv Sourasky
Medical Center, Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv 64239, Israel
The authors have no financial interest in the subject
matter of this poster
Introduction
• Pterygium is a common fibrovascular lesion,
related to sun exposure.
• Prevalence and recurrence varies
geographically.
• Trend to higher incidence with higher exposure
to UV.
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Saw SM, Tan D. Ophthalmic Epidemiol. 1999 Sep;6(3):219-28.
Avisar R, Savir H, Shoenfeld Y. Harefuah 1978;95:69±70
= range of values
Sharma A et al Ophthalmic Surg Lasers 2000;31:301±7.
Rao SK et al. Indian J Ophthalmol 1998;46:203±9.
de Keizer RJ. Int Ophthalmol 1997/98;21:335±41.
Mahar PS. Eye 1997;11(Pt 6):790±2.
Prabhasawat P et al. Ophthalmology 1997;104:974±85.
Introduction
• Fluctuations in results could also be
partly due to methods of subject data
collection.
• Studies show that most recurrences occur in
the first year after surgery.
• Follow-up over a longer duration may show a
larger prevalence of pterygium recurrence.
Aim
• To evaluate the long term survival-rate
(i.e. probability of recurrence free eye
over time) after pterygium excision with
conjunctival autograft.
Materials and Methods
• Retrospective analysis of data for
patients undergoing excision of
pterygium and sutured conjunctival
autograft in TASMC during the years
1997-2008 by a single surgeon (DV).
• The patients with short follow-up time
were invited for prospective
examination.
Results
• 182 procedures on 173 patients.
• Average follow-up time was 1047
days (range 1-3949 days, S.D.
1101).
• There were no major complications
observed in this study.
Results
• There were 20 recurrences
of pterygium (20/182,
11.4%).
• Eighty nine percent of
recurrences showed a
radial size of the
recurrent pterygium of
under 2 mm.
Time
to recurrence
Results
• Corresponded
to a
calculated
recurrence
free survival
rate of 60.9%
over more than
100 months
follow-up,
using KaplanMeyer
analysis.
Pterygium free survival
over time
Discussion
• Longest follow-up was 3949 days (130
months).
• Longest total follow-up times in the
literature:2466 days (81 months)1
69.91 ± 12.41 months2
1. Hirst LW. Ophthalmology 2009;116:1278–1286
2. Özer A. et al. Ophthalmologica 2009;223:269-273
Discussion
• It was observed that recurrences
continue throughout the entire followup period.
• Increased recurrence rate in this study
compared to others, most probably
reflects the significantly longer
follow-up period and suggests that
previous studies may underestimate true
recurrence post surgery.
Conclusion
• Using survival-rate statistics for
recurrence of pterygium in patients
after pterygium excision with
conjunctival autograft shows that the
potential for pterygium recurrence is
much greater than that reported in the
current literature.
• Survival-rate analysis is the correct
way to present results of this nature.
Presenting percentage of recurrence has
little descriptive value.