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. 2020 Jul;40(7):1781-1788.
doi: 10.1007/s10792-020-01347-y. Epub 2020 Mar 20.

Clinical demographics of pterygium excision and prevalence of conjunctival intraepithelial neoplasia: a 15-year review

Kuo-Hsuan Hung  1   2   3 , Ching-Hsi Hsiao  1   2 , Hsin-Yuan Tan  1   2 , Hung-Chi Chen  1   2 , David Hui-Kang Ma  1   2 , Hsin-Chiung Lin  1   2 , Lung-Kun Yeh  4   5
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Clinical demographics of pterygium excision and prevalence of conjunctival intraepithelial neoplasia: a 15-year review

Kuo-Hsuan Hung et al. Int Ophthalmol. 2020 Jul.

Abstract

Purpose: To find clinical demographics of pterygium surgery and prevalence of conjunctival intraepithelial neoplasia (CIN) in pterygium specimen.

Methods: This is a retrospective, institutional study. The records of patients who had received pterygium excision from 2000 to 2014 were reviewed. Patients after complete ophthalmic "examinations", surgical procedures, and pathological reports were enrolled. Surgical procedures, pathology, external eye photography, prevalence of CIN in specimen, and demographic data were described.

Results: Of 1787 pterygium cases, 928 were male and 859 were female. The mean age was 65.19 ± 14.21 years. Of these 1787 cases, 1435 (80.3%) cases had primary pterygium excision, while the others (n = 352; 19.7%) had pterygium excision for recurrence. Four cases presented CIN within pterygium tissue (0.22%). The mean age of pterygium patients with CIN was 57.75 ± 7.80 years. In stratified data, our patients who received primary and secondary pterygium excision were found prevalent in the eighth (28.2%) and seventh (26.1%) decade, respectively. Twelve percent of patients who underwent secondary pterygium excision had a recurrence and required another surgery. Patients requiring amniotic membrane transplantation (AMT) during primary pterygium excision were significantly younger (median, 58 years) than those (median, 67 years) without the assistance of AMT (p < 0.001). Similarly, AMT was utilized in younger patients (median, 56 years) during secondary pterygium excision, compared to those without AMT (median, 64 years) (p = 0.001).

Conclusion: CIN combined with pterygium is very rare. However, the possibility of the development of ocular surface squamous neoplasia in pterygium tissue should not be ignored. Meticulous pathological investigation of the surgical samples is important.

Keywords: Amniotic membrane transplantation; Conjunctival intraepithelial neoplasm; Excisional biopsy; Prevalence; Pterygium.

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