Tear film stability after pterygium excision and autologous corneal limbal stem cells transplantation versus simple pterygium excision

BACKGROUND: Treatment methods of pterygium mainly include pterygium excision, pterygium excision combined with local application of mitomycin, pterygium excision combined with conjunctival flap transfusion and pterygium excision combined with autologous corneal limbus stem cell transplantation. Dry eye commonly occurred in many patients following pterygium excision. OBJECTIVE: To evaluate the effects of stem cell transplantation of limbus cornea and simple excision of pterygium on tear film stability. METHODS: Eighty patients (eighty eyes) with pterygium were involved in this clinical experiment. All patients were randomly divided into 2 groups: Group A accepted simple excision of pterygium in 40 patients with 40 eyes under a 10-fold microscope, and Group B accepted excision of pterygium with stem cell transplantation of limbus cornea in 40 patients with 40 eyes under a 10-fold microscope, in which a free transplantation of the superotemporal limbus stem with an adjacent piece of conjunctiva was transplanted in the excision area. Slit-lamp examination, tear film break-up time and questionnaire on dry eye were performed before operation, at one week post-operation, and at three months post-operation. RESULTS AND CONCLUSION: In both groups, following surgery, some patients affected dryness, foreign body sensation, burning sensation. These symptoms were more in the group A compared with group B (P < 0.05). Implant was red 1 week following surgery in the group B, and confluence was found, without infection or rejection. The tear film break-up time was prolonged in the group B compared with the group A at 1 week following surgery, and no significant difference was determined at 3 months. Results indicated that compared with simple excision of pterygium, combined excision of pterygium with stem cell transplantation of limbus cornea obtained better outcomes, and could decrease the manifestations of dry eye and maintain better tear film stability in patients with pterygium.