Inferior Temporal Conjunctival Autograft in Pterygium Surgery

Abstract

Objectives: To evaluate the results of pterygium excision surgery with inferior conjunctival autograft application. Materials and Methods: Twenthy-eight pterygiums of 27 patients that were excissed with autografts from inferior temporal quadrant under topical anesthesia with lidocaine gelly or local subconjuctival injection anesthesia were enrolled to the study. The postoperatif complications and recurrence rates were evaluated Results: Fifteen men and 12 women with a mean age of 47.7±11.57 were enrolled to the study. The mean follow-up period was 16.4±6.82 months. Recurrence was observed in 7.1% of the cases. Dellen formation was observed in 2 (7.1%) of the cases. Over reacting fibroblastic activity and thick fibrous tissue development was observed in 3 (10.7%) of the cases. Symblepharone formation was observed in 2 (7.1%) of the cases. Conculation: Pterygium surgery with autograft application from the inferior temporal quadrant results with post-operative complications not lower than the previously documented methods. However for the patients who are probabale candidate for future glaucoma surgery this technique as it well protects the superior quadrants may be applied. ©2006, Fırat Üniversitesi, Tıp Fakültesi

Keywords

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Piterjium Cerrahisinde Alt Temporal Konjonktival Greft Uygulaması

Abstract

Amaç: İnferior konjonktival otogreft yöntemi ile yapılan pterjium cerrahisinin etkinliğini araştırmak. Gereç ve Yöntem: Primer piterjiumu olan 27 hastanın 28 gözüne topikal jel anestezisi veya subkonjonktival anestezi altında piterjium eksizyonu ve alt temporalden alınan konjonktival otogreft transplantasyonu yapıldı. Hastalar postoperatif komplikasyon ve nüks açısından değerlendirildi. Bulgular: 27 hastanın 12 tanesi kadın 15 tanesi erkekti. Hastaların yaş ortalaması 47.7±11.57 yıldı. Hastalar ortalama 16.4±6.82 ay takip edildiler. Nüks %7.1 oranında görüldü. İki olguda donör sahada dellen oluştu (%7.1). Üç olguda donör sahada fibröz doku oluştu (%10.7). İki olguda %7.1 sembleferon gelişti. Sonuç: Bu yöntemle yapılan piterjium operasyonlarında komplikasyon oranı yönteme göre yerine klasik otogreft yöntemine göre daha iyi değil, ancak ilerde glokom operasyonu olma ihtimali bulunan hastalara uygulanabilir. ©2006, Fırat Üniversitesi, Tıp Fakültesi

Keywords

• Piterjium, konjonktival otogreft, nüks

References

1. Touhami A, Di Pascuale MA, Kawatika T, Del Valle M, Rosa RH Jr, Dubovy S,Tseng SC. Characterisation of myofibroblasts in fibrovascular tissues of primary and recurrent pterygia. Br J Ophthalmol 2005;89:269-74.
2. Jaros PA, Deluisa VP. Pinguecula and pterygia. Surv Ophthalmol 1988;33:41–9.
3. Cardillo JA, Alves MR, Ambrosio LE, Poterio MB, Jose NK. Single intraoperative application versus postoperativ mitomycin C eye drops in pterygium surgery. Ophthalmology 1995;102:1949 –1952.
4. Lam DS, Wong AK, Fan DS ve ark. Intraoperative mitomycin C to prevent recurrence of pterygium after excision: a 30-month follow-up study. Ophthalmology 1998;105:901–904.
5. Lewallen S. A randomized trial of conjunctival autografting for pterygium in the tropics. Ophthalmology 1989;96:1612–1624.
6. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104:974 – 985.
7. Solomon A, Pires RT, Tseng SC. Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia. Ophthalmology 2001;108:449–460.
8. Ma DH, See LC, Liau SB, Tsai RJ. Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000;84:973– 978.

9. Jap A, Chan C, Lim L, Tan DT. Conjunctival autorotation autograft for pterygium. An alternative to conjunctival autografting. Ophthalmology 1999;106:67–71.
10. Bekibele CO, Baiyeroju AM, Ajayi BG. 5-fluorouracil vs. beta- irradiation in the prevention of pterygium recurrence. Int J Clin Pract 2004;58:920-3.
11. Rubinfeld RS, Pfister RR, Stein RM ve ark. Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmology 1992;99:1647–1654.
12. MacKenzie FD, Hirst LW, Kynaston B, Bain C. Recurrence rate and complications after beta irradiation for pterygia. Ophthalmology 1991;98:1776 –1780.
13. Kim S, Yang Y, Kim J. Primary pterygium surgery using the inferior conjunctival transposition flap. Ophthalmic Surg Lasers 1998;29:608–11.
14. Syam PP, Eleftheriadis H, Liu CS. Inferior conjunctival autograft for primary pterygia. Ophthalmology 2003 ;110:806-10.
15. Jaros PA, Deluisa VP. Pinguecula and pterygia. Surv Ophthalmol 1988;33:41–9
16. Ma DHK, See LC, Liau SB, Tsai RJF. Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C drops. Br J Ophthalmol 2000;84:973–8.
17. Solomon A, Pires RTF, Tseng SCG. Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia. Ophthalmology 2001;108:449–60.
18. Rubinfeld RS, Pfister RR, Stein RM ve ark. Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmology 1992;99:1647–54.
19. Figueiredo RS, Cohen EJ, Gomes JAP ve ark. Conjunctival autograft for pterygium surgery: How well does it prevent recurrence. Ophthalmic Surg Lasers 1997;28:99–104.
20. Allan BDS, Short P, Crawford GJ ve ark. Pterygium excision with conjunctival autografting: an effective and safe technique. Br J Ophthalmol 1993;77:698–701.
21. Kabul Tarihi: 31.05.2006