AS-OCT assessment of limbal epithelial thickness at 12 months after pterygium surgery: a comparison of conjunctival limbal autograft and conjunctival flap techniques.

PURPOSE: To compare postoperative limbal epithelial thickness (LET) measured by anterior segment optical coherence tomography (AS-OCT) following conjunctival limbal autograft (CLAU) and conjunctival flap (CF) surgery in patients with primary grade 3 pterygium. METHODS: This retrospective comparative study included 42 patients with primary grade 3 pterygium who underwent either CLAU (n = 21) or CF (n = 21). At 12 months postoperatively, AS-OCT was used to measure LET together with peripheral and central corneal epithelial and stromal thicknesses. Corresponding healthy fellow eyes served as controls. Secondary outcomes included best-corrected visual acuity (BCVA), operative duration, and recurrence. Between-group and within-group comparisons were performed using appropriate statistical tests. RESULTS: Mean postoperative LET was 61.33 ± 2.41 µm in the CLAU group and 62.81 ± 5.86 µm in the CF group, with no significant difference between groups (p = 0.141). LET did not differ significantly between operated and fellow eyes in either group. Likewise, peripheral and central corneal epithelial and stromal thicknesses were comparable between operated and fellow eyes and showed no significant differences between surgical techniques. BCVA and recurrence rates were similar in both groups, whereas operative duration was significantly shorter in the CF group (23.90 ± 1.67 vs. 40.29 ± 2.98 min, p < 0.001). No intraoperative or postoperative complications or recurrences were observed during the 12-month follow-up. CONCLUSIONS: At the 12-month postoperative evaluation, CLAU and CF demonstrated similar AS-OCT-based limbal epithelial thickness and corneal structural measurements. Although CF required a significantly shorter operative time, these findings should not be interpreted as evidence of equivalence between the two techniques. Larger prospective studies with serial postoperative AS-OCT assessments are warranted.