Long-term follow-up results of lamellar keratoplasty as a treatment for recurrent pterygium and for scleral necrosis induced by beta-irradiation.

Purpose: To evaluate the efficacy and safety of lamellar keratoplasty (LK) in the treatment of recurrent pterygium and of scleral necrosis induced by (3-irradiation. Methods: A retrospective review of patients who, between 1988 and 2001, underwent LK for the above indications. Recurrence rates, tectonic outcomes, pre- and postoperative visual acuities, and complications were analyzed. Results: In the recurrent pterygium group, LK was performed on 68 eyes. The mean age (mean ′ SD) at presentation was 45.1 ′ 13.7 years (range 17 to 77). The recurrence rate following LK was 5.9%, with a mean time to recurrence of 6.2 ′ 2.9 months (range 3 to 10). In all cases, the recurrence occurred above or below the lamellar grafts, and a second LK prevented any further recurrence. The mean length of follow-up was 27.1 ′ 26.6 months (range 3 to 132). The best-corrected visual acuity (BCVA) improved or remained unchanged in 65 of the 68 eyes (95.6%) but was reduced in the remaining three eyes (4.4%). In the scleral radionecrosis group, LK was performed on 30 eyes. The mean age at presentation was 67.7 ′ 10.3 years (range 37 to 85). Tectonic restoration was achieved in all patients. The mean length of follow-up was 49.0 ′ 45.1 months (range 8 to 120). The BCVA improved or remained unchanged in all patients. No significant complications were identified. Conclusion: Lamellar keratoplasty is a safe and effective treatment option for both recurrent pterygium and β-irradiation-induced scleral necrosis. In our opinion, LK is the treatment of choice for multiple or aggressive recurrences of pterygium and a successful management option for scleral radionecrosis.