Free conjuctival autograft in the management of advanced primary and recurrent pterygia

Sultan, Amir; Bejiga, Abebe

doi:10.4314/eamj.v77i11.46727

Cited by 8 publications

(6 citation statements)

References 17 publications

(31 reference statements)

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“…Many surgical techniques have been employed to treat pterygium; however, recurrence has been observed in many of these methods [12] . Highest rate of recurrence was reported in bare sclera technique [13] . In conjunctival graft technique, the recurrence rate was reported to vary between 3.5 and 39 percent [14] .…”

Section: Discussionmentioning

confidence: 98%

Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Abdelkader

2019

International Journal of Ophthalmic Research

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OBJECTIVE: To evaluate and compare the efficacy of using conjunctival autograft and non-bare sclera mitomycin C (MMC) techniques as two treatment options for primary pterygium. PATIENTS AND METHODS: Retrospective comparative study included 55 eyes in 55 patients with primary pterygium. 30 eyes of 30 patients (group 1) underwent pterygium excision followed by conjunctival autograft. 25 eyes of 25 patients (group 2) underwent pterygium removal followed by intraoperative application of 0.02% MMC for 2 minutes with conjunctival preservation (non-bare sclera technique). Both groups were compared in terms of surgery time, pterygium size, cosmetic effect, pterygium recurrence and complications. RESULTS: Mean pterygium size was (3.1 ± 0.64 mm and 2.6 ± 0.94 mm) in group 1 and 2, respectively (p =0.1). Mean surgery time was significantly shorter in MMC group (26.4 ± 6.39 min) as compared to conjunctival autograft group (47.9 ± 11.7 min) (P < 0.0001). Pterygium recurrence was not seen in any of the patients. Mean follow up time was (14.8 ± 6 and 17.2 ± 9.6 months) in group 1 and 2, respectively (p = 0.4). CONCLUSION: Both conjunctival graft and non-bare sclera MMC techniques are comparable as regard of pterygium recurrence. MMC technique has significantly shorter surgery time, better cosmoses and lower incidence of complications. Preserving the conjunctiva should be considered when the patient has a history of glaucoma or there is insufficient conjunctiva.

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Section: Discussionmentioning

confidence: 98%

Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Abdelkader

2019

International Journal of Ophthalmic Research

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“…Reported recurrence rates ranged between 1% and 15% (24)(25)(26). In literature, the success rates of conjunctival autograft were reported between 5% and 30% (11,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36); however, for limbal conjunctival autograft technique, recurrence rates varying between 0% and 15% have been indicated (37)(38)(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Titanium-Platelet-Rich Autograft: A Preliminary Report

Nuhoglu¹,

Tuğcu²,

Tunalı³

et al. 2018

JAREM

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The present study aimed to evaluate the effectiveness and reliability of titanium-platelet-rich fibrin (T-PRF) autograft implantation in patients who underwent this treatment method.Methods: Our study included patients who underwent titanium-platelet-rich membrane autograft implantation at our clinic for the management of primary pterygium. Demographic characteristics of patients, size of the pterygium as determined during pre-and postoperative biomicroscopic examinations, presence of granulation tissue, recurrence, corneal, and other complications, condition of the implanted graft, and conjunctival epithelization were evaluated. The absence of recurrence was considered as a criterion of success.Results: Twelve eyes belonging to total 12 patients (men, 5 and women, 7) with a mean age of 52.1±12.6 (range, 30-75) years and mean followup period of 2.91±1.37 (range, 1-5) months were included in the study. The follow-up period of total 8 cases exceeded 3 months. Recurrence was observed in 2 (16.6%) cases. Conclusion:Because no complications were oberved our study, this new surgical technique was considered reliable. Based on our preliminary reports, T-PRF autograft technique can be used as an alternative to other surgical techniques.

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“…However, the recurrence rate varies based on the surgery type, selection conditions of the patient, and geographical situation ( 13 ). According to the literature, the recurrence rate in bare sclera and mitomycin C methods has been 24–68% and 4.1–13%, respectively ( 14 ). The recurrence rate in the conjunctival autograft was reported to vary between 3.5 and 39 percent ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial

2017

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BackgroundPterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence.Objectiveto compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium.MethodsThis randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21.ResultsThe mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation’s outcome (p=0.017).ConclusionCRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva.Clinical trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016092119581N2.FundingThe study was financially supported by Shiraz University of Medical Sciences (SUMS) (grants No. 8901).

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Free conjuctival autograft in the management of advanced primary and recurrent pterygia

Cited by 8 publications

References 17 publications

Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Effectiveness of Titanium-Platelet-Rich Autograft: A Preliminary Report

Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial

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