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Cornea. 2003 Oct;22(7):612-8.

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

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Sydney Hospital and Sydney Eye Hospital, Sydney, Australia.



To evaluate the efficacy and safety of lamellar keratoplasty (LK) in the treatment of recurrent pterygium and of scleral necrosis induced by beta-irradiation.


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.


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.


Lamellar keratoplasty is a safe and effective treatment option for both recurrent pterygium and beta-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.

[Indexed for MEDLINE]

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