Clinical outcomes of Z‑shaped incision without epithelial resection in pterygium surgery: A multicenter study

Our previous study reported a novel technique for pterygium surgery: A Z-shaped incision without epithelial resection (non-resection technique).This technique is characterized by reduced intraoperative bleeding and easy conjunctival-flap creation.The present multicenter, retrospective, observational study aimed to determine the clinical outcomes of the non-resection method in patients with pterygia.Patients who underwent pterygium surgery using the non-resection technique and were followed-up >6 months were included.A total of 127 eyes from 117 patients (56 men and 61 women) with pterygia were included.Clinical data such as patient sex, age, pterygium size and postoperative recurrence were retrieved from the medical records of seven ophthalmic centers.The pterygium size was divided into four grades based on the pupillary coverage by the pterygial tissues.The mean age of the patients at the time of surgery was 73 years.Pterygia were located at the nasal, temporal and combined sites in 124, 0 and 3 eyes, respectively.Primary and recurrent pterygia were observed in 113 and 14 eyes, respectively.The mean pterygial size was grade 2.6.The follow-up duration ranged from 6 to 82 months (mean, 31 months), and postoperative recurrence was noted in 10 eyes (7.9%).The mean duration from surgery to recurrence was 20 months.Recurrence after surgery for recurrent pterygia was observed in 3 eyes from 3 patients, and the mean pterygial size was grade 3.4.The preoperative pterygium size was significantly greater in eyes with recurrence than in those without recurrence (P<0.01).No eyes exhibited tumor formation during the follow-up periods.Although the non-resection method was not superior to previous methods for pterygial surgery in terms of postoperative recurrence rates, this procedure is simple and safe and requires no additional surgery.