A Comparative Analysis of Outcomes of Pterygium Surgery with or without Collagen Matrix Implantation

Background: Pterygium is a common disorder in many parts of the world, with reported prevalence rates ranging from 0.3 to 29%. Epidemiological studies have proposed an association with chronic exposure to sunlight and an increased geographical prevalence within a peri-equatorial ‘pterygium belt’ region (1). Pterygium excision is often combined with various adjunctive measures to prevent its recurrence, however recurrenece is still the most common post-surgical complication. Numerous techniques have been attempted to reduce localized fibrovascular activity and the overall rate of recurrence; these include, β-irradiation, conjunctival and limbal auto-grafting, antimitotic drugs and amniotic membrane transplantation (2). In recent years, a novel bioengineered product has been advocated for preventing recurrence and has shown promising outcomes in animal models This study was conducted to compare the effect of collagen matrix implant with conjunctival autograft following pterygium surgery (treatment group) with only conjunctival autograft following pterygium surgery (control group). Methods: Following informed consent, sixty eyes of 60 patients (females = 23, males =37, aged 23–67 years) were randomly allocated into two equal groups. Pterygia of all patients were excised and conjunctival autograft was done. However, for patients in the treatment group a 1×3 mm collagen matrix graft (Ologen) was implanted subconjunctivally under the graft. Patients were followed up for six months. The parameters studied were patient comfort, foreign body sensation, dellen formation, pterygium recurrence and time for absorption of the collagen matrix. Results: Results revealed that no eyes in the control group and one eye in the intervention group developed recurrence; dellen formation not was observed in any patient in both groups. Patient comfort and foreign body sensation did not differ significantly in both groups. Three eyes in treatment group developed a tenon’s cyst. In 12 out of 30 eyes, the collagen matrix was not absorbed at six months post surgery. Conclusion: In conclusion, the use of biodegradable collagen matrix implants (Ologen) following pterygium excision did not seem to be associated with a lower risk of recurrence. Moreover, tenon’s cyst formation and persistence of the matrix subconjunctivally was observed. Further studies with adequate sample size are recommended for more comprehensive conclusion.