Application of platelet-rich fibrin membrane versus amniotic membrane graft transplantation after pterygium excision: a randomised clinical trial
In brief
Amniotic membrane lowers pterygium recurrence to 28% versus 42% with platelet-rich fibrin and gives superior cosmetic
In a randomized trial of 80 eyes, recurrence at one year was 28% after amniotic membrane grafting compared with 42% after platelet-rich fibrin, a difference that did not reach statistical significance, but patients reported better appearance with amniotic membrane. Surgical time was similar, while platelet-rich fibrin caused more pain and required more 5-fluorouracil injections. The findings suggest amniotic membrane may be preferred for aesthetics, though both methods have comparable safety.
- Journal
- Eye (London, England) (Q1)
- Published
- 28 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Nathapon Treewipanon, Taniya Bhoopat, Tanate Chira-Adisai, Sunee Chansangpetch, Surat Saengjinda
- PMID
- 42521759
- DOI
- 10.1038/s41433-026-04773-x
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 2 August 2026): RCT of PRF vs amniotic membrane after pterygium excision
- Picked for Transplantation (top studies of the week, 2 August 2026): High-quality evidence in a top journal
Abstract
PURPOSE: To compare the efficacy and safety of platelet-rich fibrin (PRF) membrane and amniotic membrane graft (AMG) transplantation in preventing recurrence after primary pterygium excision. METHODS: This prospective, single-blind, randomised clinical trial was conducted at Naresuan University Hospital. Eighty eyes with primary pterygium were randomly assigned to undergo either PRF membrane or AMG transplantation in a 1:1 ratio. Follow-up assessments were performed at 1 week, 1, 3, 6 and 12 months postoperatively. Outcomes included recurrence, surgical time, perioperative pain, complications, epithelialisation and the need for 5-fluorouracil (5-FU) injections. Recurrence was analysed using multilevel mixed-effects Poisson regression and Kaplan-Meier survival analysis. RESULTS: At 12 months, recurrence occurred in 41.7% of PRF eyes and 28.2% of AMG eyes (P = 0.22), with no significant difference in recurrence-free survival (P = 0.16). Better cosmetic outcomes were observed in the AMG group (P = 0.004). Surgical time was comparable between groups (37.2 vs 36.8 min; P = 0.81), while perioperative pain was higher in the PRF group (4.0 ± 1.9 vs 2.5 ± 2.1; P = 0.001). Complication rates and epithelialisation were similar between groups (P = 1.00 and P = 0.50, respectively). The PRF group required more 5-FU injections than the AMG group (80% vs 42.5%; P < 0.001). CONCLUSIONS: PRF membrane grafting results in comparable recurrence and complication rates to AMG transplantation and is advantageous because of its simple preparation and autologous nature. However, the patients in PRF group had less favourable cosmetic outcomes.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.