AIM: To compare long-term outcomes and recurrence rates of narrow versus wide inferior limbal conjunctival autograft transplants combined with Mitomycin C in primary pterygium surgery.

METHODS: This retrospective study included 146 consecutive patients(193 eyes)with primary pterygium. Ninety-one eyes had a narrow inferior limbal conjunctival autograft transplant(NI-LCAT)and 102 had a wide inferior limbal conjunctival autograft transplant(WI-LCAT)combined with Mitomycin C application. Outcome measures included recurrence rate, residual conjunctival bed status, and complications.

RESULTS: The recurrence rate in the NI-LCAT and WI-LCAT group was 3.3% and 4.9%, respectively(P=0.844). The grade of residual bed appearance in the NI-LCAT group was similar to the WI-LCAT group. Mild to moderate conjunctival scarring at the donor site was the most common complication in both groups(18.6% and 13.2% in NI-LCAT and WI-LCAT groups, respectively). There were no significant differences in the incidence of any other complications including subconjunctival epithelial cyst and granuloma at the recipient site between the two groups. Kaplan-Meier survival analysis showed that the cumulative probabilities of success between the two groups were not statistically significantly different.

CONCLUSION: Both NI-LCAT and WI-LCAT combined with Mitomycin C in primary pterygium surgery have low recurrence rates. Compared with WI-LCAT, NI-LCAT technique is found to be less traumatic and an effective surgery in terms of preserving the superior and inferior conjunctiva.