A Survey of Surgical Techniques in Pterygium, Thailand 2016

BACKGROUND: Pterygium causes a significant ocular disturbance which usually requires surgical removal; however, recurrence of pterygium after surgery frustrates both patients and surgeons. This survey aimed to determine the current surgical approaches in primary and recurrent pterygium, and the ideal surgical techniques among Thai ophthalmologists. METHODS: Questionnaires were sent to 1150 ophthalmologists who are members of Royal College of Ophthalmologists of Thailand (RCOPT). A survey was conducted between 21 September and December 21, 2016. RESULTS: 438 of 515 responded questionnaires were valid. The highest number of the respondents applied the bare sclera technique (BST) (37.4%) and conjunctival autograft transplantation (CAGT, 44.9%) in primary pterygium and recurrent pterygium, respectively. The recurrence was the most reported late postoperative complication. An ideal technique for primary pterygium surgery was CAGT (42.4%), whereas amniotic membrane transplant (AMT) with adjuvant therapy (27.4%) was most selected for recurrent pterygium. Around half of the respondents currently applied the ideal techniques in their practice. The inaccessible and unaffordable amniotic membranes or fibrin glues (58%) concerning about complications (26%), inexperience in surgical procedures (25%), large number of patients in the surgery waiting list, prolonged surgical time, and need for conjunctiva preservation in glaucoma patients were reported as the obstacles to the ideal techniques. CONCLUSIONS: BST and CAGT were the most selected surgical techniques for primary and recurrent pterygium, respectively. Better provision and distribution of amniotic membranes and fibrin glue along with training courses would promote the ideal surgical techniques.