Background: Repeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent\npterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in\nlimbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium.\nMethods: Retrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without\n(control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and\npostoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were\ncollected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were\nperformed to monitor the cornea epithelium healing and cellular recovery process respectively.\nResults: A total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK.\nThe mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and\n13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: - 0.88, 2.81), SAI decreased 0.53\n(range: - 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding\nvalues were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group,\nrespectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both\ngroups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: - 0.12, 0.50)\nin the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and\nbetter cellular recovery.\nConclusions: For recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved\ncorneal surface and vision outcomes.
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