Evaluation of the recurrence rate for pterygium treated with conjunctival autograft

Kocamış, Özkan; Bilgeç, Mustafa Değer

doi:10.1007/s00417-014-2581-y

Cited by 28 publications

(21 citation statements)

References 18 publications

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“…3 months in the HD-AM group as against 3.4 months in the CG group. This result correlated with a study by Kocamis, in which the average recurrence time was 4.5 months in conjunctival autografting [30]. This phenomenon suggests that conjunctival autografting provides a source of conjunctival epithelium and may eventually breach, whereas HD-AM seems to play a role in inhibiting the involvement of progenitor cells in pterygium recurrence [31].…”

Section: Discussionsupporting

confidence: 88%

Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium

Pan¹

2018

http://isrctn.com/

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Background: The purpose of this study was to evaluate the safety and effectiveness of the hyperdry amniotic membrane transplantation compared with conjunctival autografting for the treatment of primary pterygium. Methods: One hundred and forty-one eyes from 130 patients with primary pterygium were treated with excision followed by hyperdry amniotic membrane or conjunctival autografting after random selection. Seventy-nine eyes from 71 patients received hyperdry amniotic membrane transplantation (HD-AM group), and 62 eyes from 59 patients received conjunctival autografting (CG group). Patients were followed up at one week and one, three, six, and 12 months post-surgery. Recurrence rate, postoperative complications, and final follow-up patient visits were prospectively evaluated. Results: The mean follow-up duration was 12.56 ± 4.35 months in the HD-AM group and 12.85 ± 3.90 months in the CG group. Recurrences were detected in four eyes (5.06%) in the HD-AM group and 13 eyes (20.97%) in the CG group. A statistically significant difference in frequency of recurrence between the two groups (P = 0.003) was observed. The cumulative non-recurrence rates at six and 12 months in all patients stratified by age and sex were not significantly different (P = 0.642 and P = 0.451, respectively, by log-rank test). Graft retraction and necrosis were not detected in the two groups during the follow-up period. Conclusion: Hyperdry amniotic membrane transplantation was effective in preventing pterygium recurrence when compared with conjunctival autografting and can be considered a preferable and safe grafting procedure for primary pterygium. Trial registration: Current Controlled Trials ISRCTN16900270, Retrospectively registered (Date of registration: 3 May 2018).

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Section: Discussionsupporting

confidence: 88%

Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium

Pan¹

2018

http://isrctn.com/

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“…This procedure yields lower recurrence rates than the bare sclera, thus resulting in long-term efficacy. [153][154][155] Conjunctival autografts can be placed using sutures or fibrin glue. Sutures are associated with postoperative discomfort, chronic inflammation, and granuloma formation.…”

Section: Treatmentmentioning

confidence: 99%

“…157,158 Overall, both procedures have yielded stable grafts. 154,155,157,159 An amniotic membrane is also used in the surgical treatment of pterygium, given that it possesses anti-inflammatory and anti-fibrotic properties. 160 Typically, it is placed over the bare sclera, with the basement membrane facing up and the stroma facing down.…”

Section: Treatmentmentioning

confidence: 99%

Molecular Basis of Pterygium Development

Cárdenas-Cantú

Zavala

Valenzuela

et al. 2014

Seminars in Ophthalmology

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Pterygium pathogenesis is mainly related to UV light exposure. However, the exact mechanisms by which it is formed have not been elucidated. Clinical advances in surgical treatment use conjunctival autografts and amniotic membranes in combination with adjuvant therapies, including mitomycin C, β-radiation, and 5-fluoroacil, to reduce recurrence. Several studies aim to unveil the molecular mechanisms underlying pterygium growth and proliferation. They demonstrate the role of different factors, such as viruses, oxidative stress, DNA methylation, apoptotic and oncogenic proteins, loss of heterozygosity, microsatellite instability, inflammatory mediators, extracellular matrix modulators, lymphangiogenesis, cell epithelial-mesenchymal transition, and alterations in cholesterol metabolism in pterygium development. Understanding the molecular basis of pterygium provides new potential therapeutic targets for its prevention and elimination. This review focuses on providing a broad overview of what is currently known regarding molecular mechanisms of pterygium pathogenesis.

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“…Yapılan cerrahi tekniğe bağlı olarak %0-67 oranında nüks bildirilmiştir. 11,12 Nüks piterjiumun tedavisi fibroblastik aktivitenin artışına bağlı daha da zorlaşmaktadır. Bu da cerrahı yeni çözüm arayışına itmiştir.…”

Section: Discussionunclassified

Oral Mucosal Grafts in Severe Pterygium: Case Report

Koçak¹,

İlhan²,

Bilgin³

et al. 2017

Turkiye Klinikleri J Ophthalmol

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iterjium, konjonktivadan başlayıp korneaya doğru ilerleyen, kanatsı özellikte fibrovasküler doku proliferasyonudur. Piterjium tedavisinde birçok tedavi yöntemi tanımlanmış olsa da piterjium cerrahi bir problem olmaya devam etmektedir. Konjonktival fornikste kısalma, semblefaron gelişimi, korneal melting varlığında ya da kornea santralini de içine alan ileri piterjiumlarda bu sorun daha da büyük olmaktadır. Nüks varlığında; komplikasyon görülme olasılığı artmakta ve tedavi başarı şansı düşmekte-dir.1 Tekrarlayan cerrahiler, limbal bölgedeki bariyer fonksiyonuna zarar vererek, fibroz doku proliferasyonunda artışı beraberinde getirmektedir. Bu komplike hâle gelmiş durum; hastada kızarıklık, batma ve sulanma; yanı Turkiye Klinikleri J Ophthalmol 2017;26(4):297-303 297 İleri Piterjiumda Oral Mukozal Greft Uygulaması Ö ÖZ ZE ET T İleri ve nüks pterjiumlar; klinikte görme keskinliğinde azalma, göz hareketlerinde kısıtlı-lıkla karşımıza gelmektedir. Tedavisinde çoğunlukla klasik cerrahi teknikler yetersiz kalmaktadır. Konjonktival otogreft tekniği kısa cerrahi süresi ve düşük nüks oranları nedeni ile tercih sebebidir. Amniyotik membran greftleri; antiinflamatuar, antianjiyogenik ve antiproteolitik aktivitesi sayesinde skar oluşumunun önüne geçebilmektedir. Konjonktival otogreft ve amniyotik membran transplantasyonunun kombine edildiği çalışmalarda iyi sonuçlar alınmaktadır. Ancak yeterli, sağ-lıklı konjonktivanın olmadığı hastalarda ek cerrahi yöntemler gerekmektedir. Bu durumda mukoza grefti kullanımı düşünülmelidir. Mukoza greftleri oral (bukkal, dudak, sert damak) ya da nazal böl-geden alınabilir. Bu çalışmada, konjonktiva ve dudak mukozası otogrefti ile amniyotik membran transplantasyonunu bir arada uyguladığımız, ileri piterjiumlu bir olgu sunulmuştur.A An na ah ht ta ar r K Ke el li im me el le er r: : Piterjium; muköz membran; transplantasyon, otolog; amniyon A AB BS ST TR RA AC CT T Severe and recurrent pterygium; come out with decreased visual acuity, limitation of eye movements in clinic. Classical surgical techniques are mostly insufficient for treatment. The technique of conjunctival autograft is preferred due to short surgery duration and low recurrence rate. Amniotic membrane grafts; may prevent the scar formation with their anti-inflammatory, anti-angiogenic and anti-proteolytic activity. In studies of amniotic membrane transplantation combined with conjunctival autograft are taken good results. If there is not enough healthy conjunctiva; additional surgical procedures are required. In this situation, use of mucosal graft should be considered. Mucosal grafts can be obtained from oral (buccal, lips, hard palate) or nasal region. In this study; we presented a combined lip mucosa and conjunctival autograft with amniotic membrane transplantation procedure, in a case of severe pterygium.

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Evaluation of the recurrence rate for pterygium treated with conjunctival autograft

Abstract: We suggest that conjunctival autografting is an effective technique in primary pterygium in terms of low recurrence rate. Increasing patient age is associated with significantly less risk of recurrence and complication.

Cited by 28 publications

References 18 publications

Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium

Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium

Molecular Basis of Pterygium Development

Oral Mucosal Grafts in Severe Pterygium: Case Report

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