Younger Age-Related Incidence of Corneal Limbitis Following Pterygium Excision Combined with Conjunctival-Limbal Autograft

Abstract

Purpose To investigate the incidence, clinical characteristics, and risk factors of corneal limbitis following pterygium excision with conjunctival-limbal autograft.Methods This retrospective study included 63 eyes of 61 patients with primary nasal pterygium who underwent pterygium excision with conjunctival-limbal autograft. Patients were assessed perioperatively using anterior segment swept-source optical coherence tomography (AS SS-OCT; Anterion, Heidelberg, Germany), and postoperative complications were evaluated during follow-up. Risk factors for corneal limbitis, including age and preoperative AS SS-OCT-guided morphological and optical parameters, were analyzed.Results Corneal limbitis occurred in 12 of 63 eyes (19.0%), with a mean onset of 19.1 ± 10.9 weeks postoperatively. Eyes with limbitis were significantly younger than those without (45.3 ± 8.1 vs. 60.5 ± 9.5 years, p < 0.001), while other demographic, clinical severity, and morphological parameters were not significantly different between the two groups. On multivariate logistic regression analysis, younger age was the only independent risk factor for postoperative corneal limbitis (p = 0.007, OR = 0.674). ROC curve analysis identified a cutoff age of 49.5 years (AUC = 0.895, sensitivity 92.2%, specificity 83.3%). The incidence of corneal limbitis was significantly higher in patients younger than 50 years (10/14 eyes, 71.4%) than in those aged 50 years or older (2/49 eyes, 4.1%) (p < 0.001). All limbitis cases resolved with anti-inflammatory treatment.Conclusions Corneal limbitis may represent a notable postoperative complication following pterygium excision with conjunctival-limbal autograft, occurring predominantly in younger patients. Younger age appeared to be associated with a higher risk, although this finding requires validation in larger cohorts.