Pterygium surgery using a conjunctival autograft

2021 ◽  
pp. 174-178
Author(s):  
M.G. Kataev ◽  
◽  
M.A. Zakharova ◽  
I.U. Trofimova ◽  
A.V. Shakhmatova ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Effective Treatment ◽  
Recurrence Rate ◽  
Intraoperative Complication ◽  
Conjunctival Autograft ◽  
Common Technique ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Different Sources

Surgery is the only effective treatment for pterygium. The most common technique is the use of a conjunctival autograft after excision of the pterygium. However, the frequency of recurrences of this method, as well as possible complications in different sources, are different. Purpose. To evaluate the efficacy, safety and recurrence rate of conjunctival autograft after pterygium excision. Material and methods. 101 patients with pterygium. aged 57.31 ± 14.7 years. The follow-up period was 1 year in 56 patients and 2 years in 45 patients. All patients underwent excision of the pterygium with conjunctival autograft. Results. An intraoperative complication can be attributed to the insufficient area of the autoconjunctival graft during its transfer to the sclera, which occurred in three patients. Postoperative complications: graft edema in 14 cases (13.86%), granuloma in the suture area was observed in 1 case (0.99%). Recurrence of pterygium was noted in only three cases (2.97%). Conclusion. The use of a conjunctival autograft in pterygium surgery has shown its effectiveness and safety, as well as a low recurrence rate. The donor zone in the upper and lateral makes it possible to excise a sufficient area of autoconjunctival graft with preservation of the intact area of possible future surgery for glaucoma. Key words: conjunctival autograft, pterygium, recurrence of pterygium.

Facilitated Tenon-Free Conjunctival Autograft Preparation and Limited Tenon Removal Technique in Pterygium Surgery

2021 ◽  
Author(s):  
Fikret Ucar ◽  
Lutfi Seyrek ◽  
Servet Cetinkaya ◽  
Huseyin Ture ◽  
Ekrem Kadioglu
Keyword(s):  
Recurrence Rate ◽  
Conjunctival Autograft ◽  
Operation Duration ◽  
Pterygium Surgery ◽  
The Mean ◽  
Pterygium Excision ◽  
Group 2 ◽  
Removal Technique ◽  
Group 1

Abstract Background The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration. Material and Methods This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017. Results The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 – 7) minutes in group 1 and 8.23 ± 1.26 (8 – 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001). Conclusions The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.

scholarly journals Outcome of Inferonasal Conjunctival Autograft in Pterygium Surgery

2021 ◽  
Vol 23 (4) ◽  
pp. 319-323
Author(s):  
Pragati Gautam Adhikari ◽  
Sagun Narayan Joshi
Keyword(s):  
Medical Records ◽  
Demographic Variables ◽  
Inclusion Criteria ◽  
Conjunctival Autograft ◽  
Donor Area ◽  
Mean Size ◽  
Pterygium Surgery ◽  
The Mean ◽  
Pterygium Excision

This study was done to evaluate the outcome of pterygium excision with inferonasal conjunctival autograft at a tertiary eye care centre. Retrospective analysis of medical records of primary pterygia patients operated by a single surgeon between 2017 to 2020 were analyzed. A total of 43 patients who met the inclusion criteria were included in the study. The demographic variables, along with size of pterygium and recurrence over a period of six month follow up was noted. The mean age of patients was 46.97 years (29-74 years). The mean size of pterygium was 3.17 mm. Recurrence was seen in 3 eyes over a period of 6 months. Graft edema was observed in 11 patients and graft hemorrhage along with congestion was seen in 8 cases which resolved over a 3 weeks follow up period. Mild conjunctival scarring was seen over donor area in 5 of the eyes. Pterygium excision with inferior conjunctival autograft is an effective alternative technique to superotemporal autograft technique.

scholarly journals Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study

2021 ◽  
Vol 14 (1) ◽  
pp. 82-87
Author(s):  
Khalil M. Al-Salem ◽  
Ahmad T.S. Saif ◽  
Passant S. Saif
Keyword(s):  
Postoperative Complications ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
University Hospital ◽  
Beta Radiation ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Excision ◽  
Group B ◽  
Primary Pterygium

Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

scholarly journals Outcomes of Vertical Split Conjunctival Autograft Using Fibrin Glue in Treatment of Primary Double-Headed Pterygia

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Tarek Roshdy Elhamaky ◽  
Ahmed Mohammed Elbarky
Keyword(s):  
Fibrin Glue ◽  
Fibrous Tissue ◽  
Effective Technique ◽  
Normal Appearance ◽  
Conjunctival Autograft ◽  
Donor Area ◽  
Good Cosmetic ◽  
Pterygium Surgery ◽  
Pterygium Excision

Purpose. To evaluate the efficiency of pterygium excision with the vertical split conjunctival technique using fibrin glue in treatment of primary double-headed pterygia. Patients and Methods. 15 eyes of 15 patients with primary double-headed pterygia that underwent vertical split conjunctival autograft pterygium surgery were retrospectively reviewed. Recurrence was defined as fibrovascular proliferation over the limbus onto the cornea. Results. The patients’ mean age was 36.92 ± 10.8 years. At 12-month follow-up, recurrence was not seen in any cases. Regarding postoperative cosmetic grading, grade 1 (the appearance of the operated site is not different from the normal appearance) was found in 12 eyes (80%) and grade 2 (some fine episcleral vessels in the excised area extending up to but not beyond the limbus and without fibrous tissue) was found in 3 eyes (20%). None of the cases showed conjunctival scarring or fibrosis at the conjunctival donor area. Preoperative Sim K astigmatism at the central 3 mm and BCVA were 3.05 ± 1.5 diopters (D) and 0.64 ± 0.26 logMAR, which improved significantly to 1.15 ± 0.84 D and 0.26 ± 0.18 logMAR at 12-month follow-up postoperatively, respectively. Conclusion. Vertical split conjunctival autograft using fibrin glue is an effective technique with good cosmetic results and low to no recurrence for primary double-headed pterygia treatment. This trial is registered with NCT03507283.

Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

2021 ◽  
Vol 2 (3) ◽  
pp. 123-126
Author(s):  
Tian-Yu Wang ◽  
◽  
Min Yang ◽  
Yi Zhang ◽  
Zhao-Yang Wang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Case Series ◽  
Operation Time ◽  
Recurrence Time ◽  
Conjunctival Autograft ◽  
Long Term Follow Up ◽  
Pterygium Surgery ◽  
Limbal Conjunctival Autograft ◽  
Primary Pterygium

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

Recurrence Rate Using Fibrin Glue-Assisted Ipsilateral Conjunctival Autograft in Pterygium Surgery: 2-Year Follow-up

Cornea ◽  
2010 ◽  
Vol 29 (11) ◽  
pp. 1211-1214 ◽  
Author(s):  
Vincenzo Sarnicola ◽  
Lorenzo Vannozzi ◽  
Paolo Alfonso Motolese
Keyword(s):  
Recurrence Rate ◽  
Fibrin Glue ◽  
Conjunctival Autograft ◽  
Pterygium Surgery

scholarly journals Twelve-Year Outcomes of Pterygium Excision with Conjunctival Autograft versus Intraoperative Mitomycin C in Double-Head Pterygium Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Tommy C. Y. Chan ◽  
Raymond L. M. Wong ◽  
Emmy Y. M. Li ◽  
Hunter K. L. Yuen ◽  
Emily F. Y. Yeung ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Clinical Assessment ◽  
Original Study ◽  
Conjunctival Autograft ◽  
Significant Difference ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Double Head

Purpose. The study aims to compare the long-term outcome of conjunctival autograft (CAU) and mitomycin C (MMC) in double-head pterygium surgery.Methods. This is a follow-up study of a comparative interventional trial. Thirty-nine eyes of the 36 patients with double-head pterygium excision in the original study 12 years ago were recruited for clinical assessment. Seven out of the 36 patients were lost. In the original study, each eye with double-head pterygium was randomized to have pterygium excision with CAU on one “head” (temporal or nasal) and MMC on the other “head.” All patients were invited for clinical assessment for conjunctival bed status and the presence of pterygium recurrence in the current study.Results. There was no significant difference between the size, morphology, and type of pterygium among the two treatment groups. The recurrence rate of CAU group and MMC group 12 years after excision was 6.3% and 28.1%, respectively (P=0.020). Among eyes without recurrence, the conjunctival bed was graded higher in the MMC group than the CAU group (P=0.024).Conclusion. The use of conjunctival autograft has a significantly lower long-term recurrence rate than mitomycin C in double-head pterygium surgery.

scholarly journals Minimally Invasive Pterygium Surgery: Sutureless Excision with Amniotic Membrane and Hydrogel Sealant

2016 ◽  
Vol 7 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Sailaja Bondalapati ◽  
Balamurali Ambati
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Amniotic Membrane ◽  
Case Series ◽  
Novel Technique ◽  
Tissue Sealant ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Age Range

Purpose: To describe a novel technique for sutureless pterygium surgery using ReSure® tissue sealant. Methods: In this retrospective observational case series, we describe a modified procedure for pterygium excision followed by amniotic membrane transplant (AMT) adhered to the corneal and conjunctival defects using ReSure tissue sealant. Results: Nine eyes of seven patients (age range: 28-80 years, 4 females and 3 males) underwent pterygium removal with AMT followed by adherence of tissue to the conjunctival edges with ReSure. No issues with transplant dislocation or failure and no intra- or postoperative complications were noted. No recurrences were noted during the follow-up period. Conclusion: ReSure may be considered as a potential sealant to adhere AMT to defective corneal and conjunctival tissues in sutureless pterygium surgery.

scholarly journals Complications and Recurrence after Pterygium Excision using Mitomycin C Eye Drops versus Sutureless and Glue Free Conjunctival Autograft: A Prospective Study

2020 ◽  
Author(s):  
Prachi Shukla ◽  
Suman Bhartiya
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Eye Drops ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Excision ◽  
The Difference ◽  
One Year ◽  
Group B

Introduction: Recurrence is the most common problem with pterygium excision. Various adjunctive methods have been described to decrease the recurrence rate of pterygium. Mitomycin C (MMC) and limbal Conjunctival Autograft (CAG) are most commonly used methods to reduce its recurrence. Aim: To compare the recurrence rate of pterygium and the complications with MMC eyedrops after bare sclera pterygium excision versus sutureless and glue free CAG. Materials and Methods: Total 104 eyes were divided into two groups (A and B) of 52 eyes each. Group A patients underwent bare sclera excision of pterygium followed by 0.01% MMC eye drops BD (twice a day) for five days and Group B patients had sutureless and glue free CAG using oozing blood as tissue adhesive after pterygium excision. The patients were followed-up postoperatively on day 1, day 3, day 7, one month, three months, six months and one year. All the patients were examined for recurrence and complications. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 16 and student’s t-test was applied for comparison. Results: A total of 104 eyes of 92 patients were divided into two groups (A and B) of 52 each. The mean age of Group A was around 45 year and group B was around 43 years and the difference was statistically insignificant (p>0.05). Total three patients had recurrence in one year of follow-up in group A, out of which first case appeared before the end of 1st month, second before the completion of 3rd month and the third case at the last follow-up. In group B only one case presented with recurrence at 6th month follow-up. The difference between the recurrences in both the groups was statistically insignificant (p>0.05). Short term complications were observed in five patients in group A. One patient had corneal thinning; one had scleral thinning, two patients presented with avascular sclera and one patient with granuloma. In group B, 18 patients with graft retraction, eight with graft oedema, five with sub-conjunctival graft haemorrhage and one with granuloma were observed. All these complications resolved by the time. Long term complications were not observed in any patient of both the groups. Conclusion: This study concluded that the use of MMC eye drops (0.01%) BD or glue free and sutureless CAG after pterygium excision is safe and effective treatment modalities for pterygium.

scholarly journals Outcome of conjunctival autograft sutured with polyamide black sutures in pterygium surgery

2013 ◽  
Vol 5 (1) ◽  
pp. 94-99 ◽  
Author(s):  
CV Kavitha
Keyword(s):  
Inflammatory Reaction ◽  
Cost Effective ◽  
Patient Comfort ◽  
Conjunctival Autograft ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
The Cost ◽  
Conjunctival Autografting ◽  
Primary Pterygium

Introduction: Pterygium excision with conjunctival autografting is the most effective way of treating pterygium with the least recurrence rate. The sutures which can be used to suture the conjunctival autograft are absorbable polyglactin 10-0 sutures or nonabsorbable polyamide 10-0 sutures. The polyamide sutures are inert, elicit minimal acute inflammatory reaction, do not support infection and allow easy removal without tissue adherence. They are very cost-effective compared to polyglactin sutures. Objective: This study was aimed to assess the efficacy of the cost-effective polyamide sutures in terms of patient comfort, graft stability, need for suture removal and recurrence. Materials and methods: In this prospective, non-comparative study, 56 eyes of 56 patients with primary pterygium underwent pterygium excision with conjunctival autograft transplantation sutured with 10-0 polyamide black sutures. The patients’ comfort, graft stability, need for suture removal and recurrence were assessed within a mean follow- up period of 28.75 months (range 47 - 14 months). Results: Mild discomfort was found in 14 (25 %) patients for up to 3 weeks, moderate discomfort in 8 (14.2 %) for up to 1 week, no patients had severe discomfort beyond the first day, and all patients were comfortable at the end of the sixth post-operative week. The graft was stable in all patients. Nine sutures in 5 patients out of 392 sutures in 56 patients, that is, 2.29 % of the sutures, needed to be removed at the end of the sixth post-operative week. Two patients, or 3.57 %, had a recurrence. Conclusion: In pterygium surgery, suturing the conjunctival autograft with cost-effective polyamide black sutures is efficient and safe. Nepal J Ophthalmol 2013; 5(9):94-99 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7833

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