Study designs of evaluations included in the review
Published randomised controlled trials (RCTs), which compared at least two of the three surgical techniques for the treatment of primary pterygium, were included if the quality of the trial was graded as 0.5 or more using the method outlined by Detsky et al. (see Other Publications of Related Interest no.1). The duration of the follow-up ranged from 1 to 33 months. Studies were excluded if they combined non-selective results from surgery on primary and recurrent pterygia, used concurrent treatment modalities, or if the published data were incomplete.
Specific interventions included in the review
The interventions included the following surgical regimes: bare sclera resection; bare sclera resection with intra-operative or post-operative mitomycin C application; and pterygium excision plus conjunctival autograft placement. Topical mitomycin was applied in doses ranging from 0.02% twice daily for 5 days, to 0.1% four times daily for 2 weeks. The surgical techniques included polishing and no polishing. The post-operative treatments included topical antibiotics or steroids for periods ranging from 3 weeks to 3 months.
Participants included in the review
Patients aged 19 to 81 years, who were receiving surgery for the treatment of primary pterygium, were included. The participants included both men and women, and those of African-American, Asian or Hispanic races.
Outcomes assessed in the review
The outcome assessed was that of post-operative pterygium recurrence. The following recurrence definitions were used: fibrovascular regrowth past limbus in area previously compromised; regrowth similar to original with symptoms; fibrovascular regrowth past limbus at least 1.5 mm with conjunctival drag; and vascular regrowth past limbus.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.