{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:08:08Z","timestamp":1780376888648,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the long-term effects of an automated eye position fixation training device (AEPFTD) on intraoperative cooperation, surgical efficiency, complications, and recurrence rates in patients undergoing pterygium surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center, double-blinded, prospective randomized controlled trial, 114 patients scheduled for unilateral primary pterygium surgery participated. Participants were randomly assigned to receive preoperative training using either the AEPFTD (experimental group, EG) or conventional manual training (control group, CG). We assessed primary outcomes of intraoperative cooperation in eye position, total operative time, and sustained maintenance of eye position. For secondary outcomes, we monitored recurrence rates at 6, 12, and 24\u202fmonths after surgery, as well as specific intraoperative complications, including conjunctival suture loosening, corneal abrasion, and conjunctival tear. We analyzed outcomes with complete data using standard between-group statistical tests. For the recurrence, we also performed a per-protocol analysis and multiple imputation to handle missing follow-up data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The EG had a significantly shorter total operative time than the CG (44.01\u202f\u00b1\u202f4.96\u202fmin vs. 46.41\u202f\u00b1\u202f4.73\u202fmin,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009). Adjustment counts for intraoperative eye position control showed no significant difference between groups (3 (1, 6) vs. 3 (1, 6) times,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.734). Both groups showed comparable sustained eye-position maintenance (140.7 [105.3, 325.4] s vs. 144.1 [93.9, 281.8] s,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.973). Both groups showed no significant differences in specific complications (conjunctival suture loosening, corneal abrasion, or conjunctival tear; all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05) or in the overall complication rate (10.53% vs. 17.54%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.236). In the PPS analysis, recurrence rates at 6\u202fmonths, 1\u202fyear, and 2\u202fyears did not differ significantly. After we used MI to handle missing follow-up data, logistic regression also showed no significant difference in the 2-year recurrence rate (OR\u202f=\u202f1.294, 95% CI: 0.295\u20135.683,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.734).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with conventional manual training, the AEPFTD reduced operative time without significant differences in intraoperative cooperation, complications, or recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1764636","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:28:06Z","timestamp":1780374486000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of the application effect of an automated eye position fixation training device in patients undergoing pterygium surgery: a two-year follow-up randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Bei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]},{"name":"Department of Ophthalmology, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Si","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqin","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huarong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Anqing Municipal Hospital","place":["Anqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongfeng","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"970394248","DOI":"10.1177\/25158414211020152","article-title":"Pterygium: an update on pathophysiology, clinical features, and management","volume":"13","author":"Shahraki","year":"2021","journal-title":"Ther Adv Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"262","DOI":"10.5935\/0004-2749.20200068","article-title":"Mechanisms and biomarker candidates in pterygium development","volume":"83","author":"Martins","year":"2020","journal-title":"Arq Bras Oftalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"616","DOI":"10.18231\/j.ijceo.2023.116","article-title":"Evaluating surgical outcome of pterygium excision with conjunctival autograft using autologous blood: can it be a new norm?","volume":"9","author":"Mahadik","year":"2023","journal-title":"Indian J Clin Exp Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1038\/eye.1993.146","article-title":"Conjunctival autografting in the surgical management of pterygium","volume":"7","author":"Riordan-Eva","year":"1993","journal-title":"Eye"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1038\/sj.eye.6701728","article-title":"Outcome of pterygium surgery: analysis over 14 years","volume":"19","author":"Fernandes","year":"2005","journal-title":"Eye"},{"key":"ref6","first-page":"2646","article-title":"A comparative study of autologous blood versus conventional conjunctival autograft surgery for pterygium","volume":"16","author":"Das","year":"2024","journal-title":"Int J Pharmaceut Clin Res"},{"key":"ref7","first-page":"1","article-title":"L\u2019autogreffe limbo-conjonctivale dans la chirurgie du pt\u00e9rygion primaire au Togo","volume":"34","author":"Maneh","year":"2017","journal-title":"Health Sci 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Nurs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"410858002","DOI":"10.1177\/01632787241291246","article-title":"Analysis of the effect of preoperative eye position fixation training in patients with pterygium: a randomized controlled trial","author":"Chu","year":"2024","journal-title":"Eval Health Prof"},{"key":"ref12","article-title":"Effect of simulated training on head and eye position during refractive error correction surgery","volume":"38","author":"Dengfen","year":"2003","journal-title":"Chin J Nurs"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3870\/hlxzz.2013.12.036","article-title":"Preoperative simulated eye position training for patients undergoing pterygium excision combined with limbal stem cell transplantation","volume":"28","author":"Liang","year":"2013","journal-title":"J Nurs Sci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"293","DOI":"10.3969\/j.issn.1672-9455.2016.25.145","article-title":"Evaluation of the importance of eye and head position training in pterygium excision combined with limbal stem cell transplantation","volume":"13","author":"Ziyan","year":"2016","journal-title":"Lab Med Clinic"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"6646","DOI":"10.1038\/s41598-025-90433-1","article-title":"Risk factors for pterygium recurrence based on a retrospective study of 196 patients","volume":"15","author":"Chen","year":"2025","journal-title":"Sci Rep"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s10384-018-0582-9","article-title":"Risk factors for pterygium recurrence after limbal-conjunctival autografting: a retrospective, single-Centre investigation","volume":"62","author":"Aidenloo","year":"2018","journal-title":"Jpn J Ophthalmol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"367","DOI":"10.4103\/joco.joco_153_20","article-title":"Recurrent pterygium: a review","volume":"33","author":"Ghiasian","year":"2021","journal-title":"J Curr Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3969\/j.issn.1671-8933.2021.05.011","article-title":"Application of preoperative gaze fixation training in elderly patients undergoing intravitreal injection","volume":"20","author":"Ying","year":"2021","journal-title":"J Clin Nurs"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3303","DOI":"10.3760\/cma.j.issn.1673-4351.2018.23.042","article-title":"Application of preoperative gaze fixation training in perioperative nursing for patients undergoing phacoemulsification cataract surgery","volume":"37","author":"Hua","year":"2018","journal-title":"Int J Nurs"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/s10792-024-03359-4","article-title":"In vivo confocal microscopy findings about ocular surface recovery in patients following pterygium excision combined with conjunctival autograft","volume":"45","author":"M","year":"2024","journal-title":"Int Ophthalmol"},{"key":"ref21","first-page":"683","article-title":"Prospective study on rate of recurrence and cosmesis in primary pterygium cases undergoing pterygium extended removal followed by extended conjunctival transplant (P.E.R.F.E.C.T.)","volume":"16","author":"Penchalaiah","year":"2024","journal-title":"Surgical Technique"}],"container-title":["Frontiers in 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