Surgical treatment of the primary pterrygium: comparison between rotation of conjunctival flap and amniotic membrane transplant

OBJECTIVE: Determine the best procedure for the treatment of the surgical primary pterygium according to the recurrence rate. DESIGN: Randomized clinical trials. MATERIAL AND METHODS: 228 patients (228 eyes) carrying primary pterygium level II diagnosed with biomicroscopy, having the surgical treatment from January 2001 to October 2005 in the surgical room of the School Hospital of UFTM. Patients were divided into two groups:Test group (126 eyes): exeresis of the pterygium followed by a transplant of amnionic membrana;Control group (102 eyes): exeresis of the pterygium followed by rotation of the conjunctival flap. Criterion of recidivation considered was the corneal invasion by the fibrovascular tissue in a period of a year after the surgery. Statistics analysis was done using the significance test for equality of two proportions. RESULTS: In the test group we observed 8 tables of recidivation, being 6 in male patients and 2 in female ones. Average age of these patients was 39.6 (ranging from 22 to 53). Recidivation occurred on an average of 3.3 months (ranging from the 2nd to the 7th month). In the control group we observed 17 recidivations of the pterygium being 11 in the male sex and 06 in the female one. The average age of these patients was 35.7 years old (ranging from 20 to 50 years). Recidivation occurred on an average of 3.1 months (ranging from the 1st to the 8th month). The calculated z (2.48) was higher than the table z. CONCLUSIONS: Amniotic membrane transplantation is an effective and safe procedure for primary pterygium surgery with a relatively low recurrence rate. However, we couldn't affirm that the amniotic membrane transplant has to be considered the first choice in the primary pterygium surgery treatment.