Background  Surgery is the main treatment method for pterygium, but it may cause damage to the conjunctiva and cornea, with the possibility of recurrence after surgery. Objective To observe and compare the effect of autologous serum on postoperative ocular surface reconstruction and prevention of recurrence after pterygium surgery.

  Methods  Seventy-five patients with pterygium who required surgical treatment in our department from June 2018 to December 2020 were randomly divided into three groups, with 25 cases in each group. Pterygium excision combined with corneal limbal stem cell transplantation was performed in all patients. Patients in the three groups were treated with various eye drops after operation. Group A was treated with polyethyleneglycol eye drops, group B with deproteinized bovine blood extract eye gel and group C with autologous serum eye drops. The tear film rupture time and basic tear secretion, the conscious symptoms, hyperemia of conjunctival flap, repair of corneal wound epithelium and recurrence were observed and recorded at pre-operation, 1 d, 3 d, 1 week, 2 weeks, 6 months and 12 months after operation.

  Results   There were 25 patients in each group, with a mean age of 57.8±7.3 years in group A, 58.8±6.9 years in group B, and 59.1±6.6 years in group C, and there were 13 male patients in group A, 11 male patients in group B, and 14 male patients in group C; there were no significant differences in sex and age between the three groups (all P >0.05). Compared with group A, groups B and C had significantly shorter regression time of subjective symptoms, complete regression time of conjunctival flap congestion, and time to complete corneal epithelial wound repair (all P <0.05). At 6 and 12 months after surgery, groups B and C had significantly longer tear break-up time and significantly higher basal tear secretion than group A (all P <0.05), and compared with group B, group C had significantly better complete regression time of conjunctival flap congestion and tear break-up time (both P <0.05). There was 1 case of recurrence (4%) in each of groups A and B at 12 months after surgery, with no case of recurrence in group C, and there was no significant difference in recurrence between the three groups ( P >0.05).

  Conclusion  Deproteinized extract of calf blood and autologous serum shows better effect than polyethylene glycol in promoting postoperative ocular surface reconstruction, and compared with deproteinized extract of calf blood, autologous serum has significant advantages and can reduce recurrence rate.