Extensive recurrent pterygium following photorefractive keratectomy: a case report.
Sadegh Ghafarian, Alireza Mojarrad, Javad Sadeghi et al.
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Case in brief
A healthy 39-year-old man developed an extensive recurrent pterygium three months after uneventful photorefractive keratectomy (PRK), having undergone primary pterygium surgery two months before PRK. The lesion crossed the visual axis, and best-corrected visual acuity was 20/60. Excision with mitomycin C and free conjunctival autografting was followed by improved vision and no recurrence at six months; mild corneal subepithelial haze was noted. At 33 months, best-corrected visual acuity was 20/20, with no sign of recurrence.
What made this case unusual
The pterygium recurred extensively across the visual axis soon after PRK, despite the recent primary pterygium surgery having preceded the refractive procedure.
Diagnostic / clinical pearl
In a patient with pterygium being considered for corneal refractive surgery, the authors emphasize choosing a pterygium technique with a low recurrence rate and allowing at least six months to confirm stability and absence of recurrence before proceeding.
Why it matters
The authors suggest that ultraviolet excimer-laser exposure and the inflammatory response to PRK may contribute to recurrence, although this single case does not establish causation.