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Practice Patterns in the Management of Primary Pterygium

A Survey Study

Graue-Hernandez, Enrique O. MD, MSc, FACS*; Córdoba, Andrea MD*; Jimenez-Corona, Aida MD, PhD*,†; Ramirez-Miranda, Arturo MD*; Navas, Alejandro MD, PhD, FACS*; Serna-Ojeda, Juan C. MD, MSc; Mannis, Mark J. MD, FACS§

doi: 10.1097/ICO.0000000000002091
Clinical Science

Purpose: To characterize cornea specialists’ current practice preferences in the management of primary pterygium.

Methods: A 25-item survey regarding indications for surgery, surgical technique, use of adjuvant therapy, type and duration of postoperative therapy, and treatment of early recurrences was designed and sent to members of the Cornea Society through the kera-net listserv.

Results: In total, 199 cornea specialists completed the questionnaire. More than 90% considered that surgery should be performed when there is proximity of the pterygium to the visual axis, pain or redness, eye movement restriction, or induction of astigmatism. Cosmesis was considered as an indication by 41.7% of the participants. The most frequent technique for pterygium excision was complete resection including the base and a moderate quantity of Tenon capsule followed by autologous conjunctival or limbal-conjunctival graft. The preferred graft fixation method in this survey was fibrin glue (61.2%). Most respondents reported a recurrence rate of less than 5% and no use of adjuvant agents to prevent recurrence. When early recurrence did occur, the preferred agents were corticosteroids.

Conclusions: This study reflects the preferences of cornea experts regarding primary pterygium treatment and may serve as a guide for the management of this pathology.

*Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”—Mexico City, Mexico;

General Directorate of Epidemiology, Health Secretariat, Mexico City, Mexico;

Aguascalientes Eye and Tissue Bank—Aguascalientes, Mexico; and

§Department of Ophthalmology & Vision Science—University of California, Davis, Sacramento, CA.

Correspondence: Enrique O. Graue-Hernandez, MD, MSc, FACS, Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana,” Chimalpopoca 14, Cuauhte[Combining Acute Accent]moc 06800, Mexico City, Mexico (e-mail:

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received November 21, 2018

Received in revised form June 17, 2019

Accepted June 20, 2019

Online date: August 8, 2019

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