AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus.

METHODS:A total of 102 patients(102 eyes)with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases(34 eyes)with simple excision of pterygium(resection group), pterygium excision combined with conjunctival flap transplantation in 34 cases(34 eyes, as conjunctival flap group)and pterygium excision combined with limbal stem cell transplantation in 34 cases(34 eyes, as stem cell group). The wound repair time, complications, recurrence rate, uncorrected visual acuity(UCVA), tear film break-up time(BUT)and basal tear secretion test(SⅠt)were observed before, and 6 and 12mo after surgery in the three groups, respectively.

RESULTS: The postoperative UCVA of the three groups was significantly higher than that preoperation(P=0.039, 0.013, 0.024), and there was no significant difference among the three groups(P=0.317). The wound repair time was 5.67±1.45d in the resection group, which was significantly higher than that in the conjunctival flap group(4.18±0.76d)and the stem cell group(4.09±0.79 d)(P<0.001), there was no significant difference between the conjunctival flap group and the stem cell group(P=0.937). There were 4 cases in resection group reappeared, and the recurrence rate was 11.8%, which was significantly higher than the other two groups(P=0.037). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2.9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation(P<0.05), especially in conjunctival flap group and stem cell group(P<0.001). There was no significant difference between the conjunctival flap group and the stem cell group(P=0.845, 0.894).

CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.