Results of Conjunctival Autograft Transplantation Combined with Amniotic Membrane Transplantation Surgery in Recurrent Pterygium Cases

Yıl 2021, , 24 - 29, 23.04.2021

Cafer Tanrıverdi , Özlem Balcı

https://doi.org/10.30565/medalanya.812065

Öz

Aim: To evaluate the results of conjunctival autograft transplantation (CAT) combined with amniotic membrane transplantation (AMT) surgery in recurrent pterygium cases.

Methods: This is a retrospective interventional case series involving patients admitted to our clinic with recurrent pterygium. Patients' examination and postoperative findings were taken through standard slit-lamp examinations. Fourteen eyes of 14 patients were included in the study. All cases were treated with excision, followed by CAT combined with AMT. Corneal recurrence was evaluated as the main result. Fibrovascular proliferation greater than 1 mm on the cornea was accepted as recurrence after surgery.

Results: The mean age of patients was 56.4 ± 7.5 (range: 40 – 65) years. During the mean follow-up period of 24.9 ± 10.7 (range: 12 – 50) months, pterygium and symblepharon recurred in only one eye (7.1%) after 4 months.

Conclusion: In this study, it was seen that acceptable results were obtain and low recurrence rates could be achieved with the combination of CAT and AMT for the treatment of recurrent pterygium.

Anahtar Kelimeler

Pterygium, conjunctival diseases, amnion, cornea

Tekrarlayan Pterjiyumlu Olgularda Konjonktival Otogreft Transplantasyonu ile Kombine Amniyotik Membran Transplantasyonu Cerrahisi Sonuçları

Öz

Amaç: Tekrarlayan pterjiumlu olguların tedavisinde konjonktival otogreft transplantasyonu (KOT) ile kombine amniyotik membran transplantasyonu (AMT) sonuçlarını değerlendirmek

Metot: Bu çalışma kliniğimize tekrarlayan pterjiyum ile başvuran hastaları içeren retrospektif girişimsel bir vaka serisidir. Hastaların muayeneleri ve postoperatif bulgular standart yarık lamba biomikroskopi ile yapıldı. Çalışmaya 14 hastanın 14 gözü alındı. Tüm olgularda pterjium eksizyonunu takiben KOT ile kombine AMT yapıldı. Ana sonuç olarak korneal nüks değerlendirildi. Kornea üzerinde 1 mm'den fazla fibrovasküler proliferasyon ameliyat sonrası rekürrens olarak kabul edildi.

Bulgular: Hastaların ortalama yaşı 56.4 ± 7.5 (aralık: 40- 65) yıldı. Ortalama 24.9 ± 10.7 (aralık: 12- 50) aylık takip süresi sonunda sadece bir gözde (% 7.1) 4 ay sonra pterjium ve symblepharon tekrarladı.

Sonuç: Bu çalışmada, tekrarlayan pterjium tedavisi için KOT ve AMT kombinasyonu ile kabul edilebilir sonuçlar alındığı ve düşük nüks oranları sağlanabileceği görüldü.

Anahtar Kelimeler

Pterjium, konjonktival hastalıklar, amnion, cornea

Kaynakça

• 1. Jaros PA, DeLuise VP. Pingueculae and pterygia. Surv Ophthalmol. 1988;33(1):41-9. doi: 10.1016/0039-6257(88)90071-9.
• 2. Lewallen S. A randomized trial of conjunctival autografting for pterygium in the tropics. Ophthalmology. 1989;96(11):1612-4. doi: 10.1016/s0161-6420(89)32667-4.
• 3. Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol. 1997 Oct;115(10):1235-40. doi: 10.1001/archopht.1997.01100160405001.
• 4. Hill JC, Maske R. Pathogenesis of pterygium. Eye (Lond). 1989;3(Pt 2):218-26. doi: 10.1038/eye.1989.31.
• 5. Young AL, Leung GY, Wong AK, Cheng LL, Lam DS. A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium. Br J Ophthalmol. 2004;88(8):995-7. doi: 10.1136/bjo.2003.036830.
• 6. Shimazaki J, Kosaka K, Shimmura S, Tsubota K. Amniotic membrane transplantation with conjunctival autograft for recurrent pterygium. Ophthalmology. 2003;110(1):119-24. doi: 10.1016/s0161-6420(02)01453-7.
• 7. Miyai T, Hara R, Nejima R, Miyata K, Yonemura T, Amano S. Limbal allograft, amniotic membrane transplantation, and intraoperative mitomycin C for recurrent pterygium. Ophthalmology. 2005;112(7):1263-7. doi: 10.1016/j.ophtha.2005.01.037.
• 8. Ti SE, Tseng SC. Management of primary and recurrent pterygium using amniotic membrane transplantation. Curr Opin Ophthalmol. 2002;13(4):204-12. doi: 10.1097/00055735-200208000-00003.
• 9. Youngson RM. Recurrence of pterygium after excision. Br J Ophthalmol. 1972;56(2):120-5. doi: 10.1136/bjo.56.2.120.
• 10. Ono T, Mori Y, Nejima R, Tokunaga T, Miyata K, Amano S. Long-term follow-up of transplantation of preserved limbal allograft and amniotic membrane for recurrent pterygium. Graefes Arch Clin Exp Ophthalmol. 2016;254(12):2425-30. doi: 10.1007/s00417-016-3483-y.
• 11. Yao YF, Qiu WY, Zhang YM, Tseng SC. Mitomycin C, amniotic membrane transplantation and limbal conjunctival autograft for treating multirecurrent pterygia with symblepharon and motility restriction. Graefes Arch Clin Exp Ophthalmol. 2006;244(2):232-6. doi: 10.1007/s00417-005-0010-y.
• 12. Fallah MR, Golabdar MR, Amozadeh J, Zare MA, Moghimi S, Fakhraee G. Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium. Eye (Lond). 2008;22(3):420-4. doi: 10.1038/sj.eye.6702657.
• 13. Sangwan VS, Murthy SI, Bansal AK, Rao GN. Surgical treatment of chronically recurring pterygium. Cornea. 2003;22(1):63-5. doi: 10.1097/00003226-200301000-00015.