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New research · Ophthalmology
The British journal of ophthalmology · 17h
Meta-analysisThe British journal of ophthalmology · 2026

Incidental ocular surface squamous neoplasia in pterygia: a systematic review and meta-analysis.

Andrew Mihalache, Ryan S Huang, Michael Balas … Clara C Chan
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OphthalmologyMeta-analysis

Incidental ocular surface squamous neoplasia found in 1.32% of clinically diagnosed pterygia.

Incidental ocular surface squamous neoplasia in pterygia: a systematic review and meta-analysis.

Andrew Mihalache … Clara C Chan
The British journal of ophthalmology · 2026
Background

This meta-analysis evaluates the prevalence and risk factors for incidental ocular surface squamous neoplasia in clinically diagnosed pterygia.

Purpose

Differentiating pterygium from ocular surface squamous neoplasia (ocular surface squamous neoplasia) is important for guiding management.

Methods

Ovid Embase, MEDLINE, Cochrane Library and Web of Science were systematically searched from January 2000 to February 2025.

n = 8688 specimens
Results

About 1 in 76 lesions thought to be pterygium were actually this malignancy.

OR by subgroup · 95% CI
null = 1
distance from the equator
0.49
UV exposure
2.20
More results

Meta-regression revealed that lower ocular surface squamous neoplasia prevalence was associated with greater distance from the equator (OR 0.49, 95% CI 0.28 to 0.83, p<0.01), while higher prevalence was associated with greater ultraviolet exposure (OR 2.20, 95% CI 1.17 to 4.14, p=0.01).

Publication year had no effect (p=0.98).

More results

Incidental ocular surface squamous neoplasia prevalence also did not differ between primary and recurrent pterygia (p=0.23).

Regional analyses revealed variation in prevalence: Europe (0.29%), Asia (0.76%), North America (1.03%), Oceania (8.57%) and South America (14.97%).

“
Conclusion · 1 of 2

This meta-analysis, based on low- to very low-certainty evidence, identified a 1.32% pooled prevalence of incidental ocular surface squamous neoplasia in clinically diagnosed pterygia, highlighting the potential influence of ultraviolet exposure and equatorial proximity.

Conclusion · 2 of 2

The overlap in demographic and lesion characteristics between benign pterygia and ocular surface squamous neoplasia underscores diagnostic challenges.

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