Tear Film Stability After Primary Pterygium Excision Combined with Limbal Stem Cell Transplantation is Superior to Amniotic Membrane Transplantation: A Meta-Analysis

Abstract Purpose To evaluate the tear film stability after primary pterygium excision combined with Limbal stem cell transplantation (LSCT) or amniotic membrane transplantation (AMT). Methods We searched the PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang and VIP databases for all studies on tear film stability after primary pterygium excision combined with LSCT or AMT. The mean difference (MD) and 95% confidence interval (CI) were calculated for outcomes using the fixed effect or random effect model.Results Seven studies with a total of 531 eyes were enrolled in our meta-analysis, which revealed that comparison between the LSCT group and the AMT group: Ocular Surface Disease Index (OSDI) 3 months postoperatively (MD=-5.16, 95%CI:-6.48,-3.85, P＜0.05), Tear break-up time (BUT) 1 or 3 months postoperatively (1 month: MD=0.30, 95%CI:-0.66,1.26, P=0.54; 3 months: MD=1.30, 95%CI:-0.13,2.72, P=0.07), Schirmer I test 1 or 3 months postoperatively (1 month: MD=0.05, 95%CI:-0.41,0.51, P=0.82; 3 months: MD=1.41, 95%CI:0.81,2.02, P＜0.05), Corneal fluorescein staining (CFS) score 1 month postoperatively (MD=-0.49, 95%CI:-1.29,0.31, P=0.23).Conclusion Primary pterygium excision combined with LSCT is associated with better tear film stability changes than AMT.