AIM: To investigate the amniotic membrane transplantation for all the cornea or bandage contact lens after pterygium excision combine with limbal stem cell transplantation in the treatment of large pterygium.

METHODS:The 40 eyes of larger pterygium was randomly divided into 2 groups, one group, 20 eyes, with autologous limbal stem cell transplantation combine with amniotic membrane transplantation for all the cornea(amniotic membrane group); another group, 20 eyes, with bandage contact lens after limbal stem cell transplantation(bandage contact lens group). The surgery time, eye comfort postoperation, progress in corneal healing were observed at 1, 3d, 1 and 3wk.

RESULTS:The average surgery time of amniotic membrane transplantation group was 61.4±5.2min, and the bandage contact lens group was 34.5±2.7min, which was significantly shorter(Student's t-test, P<0.05). There was no difference of the degree of eye comfort between the two groups at first day after surgery. But 3d and 1wk postoperation, the degree of ocular comfort of bandage contact lens group was much better than amniotic membrane transplantation group(P<0.01), while there was no difference between the two groups 3wk after surgery(P>0.05). The corneal healing score of the two groups was 0.85±0.18 and 1.15±0.18 in the 3wk after operation respectively, and the difference between the two groups was not statistically significant(Student's t-test, P=0.25). There was only one case of recurrence in amniotic membrane group.

CONCLUSION:Treatment of larger pterygium with amniotic membrane transplantation for all the cornea or wearing bandage contact lenses after autologous limbal stem cell transplantation, can both ease eye symptoms and promote corneal wound healing. Those patients with bandage contact lens feel more comfortable and convenient than with autologous limbal stem cell transplantation. Also the bandage contact lens surgery is more economical than the other one.