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  • Cornea/External Disease

    Review of: Risk factors associated with pterygium reoperation in the IRIS Registry

    Oke I, Hall N, Elze T, et al. JAMA Ophthalmology, November 2022

    An investigation into factors that could be linked with pterygium reoperation reveals significant associations with surgeon characteristics and patient age, ethnicity, and location.

    Study design

    This retrospective cohort study used deidentified data from the Intelligent Research in Sight (IRIS) Registry. A total of 87,042 patients who had single pterygium surgery with a graft from January 1, 2013, through December 31, 2020, were included. Risk factors associated with pterygium reoperation were assessed using multivariable Cox proportional hazards regression models.


    The probability of reoperation within 5 years of surgery was 5.7%. Higher probability of reoperation was significantly associated with factors such as younger age, male sex, having public insurance, living in the Northeast United States, and having surgery performed by a low-volume surgeon. There was a lower probability of reoperation when surgery was done by a cornea specialist.


    Although patient and surgeon characteristics are evaluated as risk factors in this study, there is no evaluation of risk factors associated with the pterygium itself or the perioperative medication regimen. There is also no evaluation of graft technique, which is often considered to be highly associated with reoperation.

    Clinical significance

    If patient risk is higher due to nonmodifiable risk factors, clinicians may consider adjusting those modifiable risk factors that are in their control, such as referring these patients to cornea specialists or high-volume surgeons. Clinicians should also aim to use techniques associated with lower recurrence risk for patients more at risk due to nonmodifiable factors.

    Financial Disclosures: Dr. Afshan Nanji discloses a financial relationship with Beyeonics Surgical (Consultant/Advisor).