Management of Recurrent Pterygium With Intraoperative Mitomycin C and Conjunctival Autograft With Fibrin Glue

Shehadeh-Mashor, Raneen; Srinivasan, Sathish; Boimer, Corey; Lee, Kenneth; Tomkins, Oren; Slomovic, Allan R.

doi:10.1016/j.ajo.2011.04.034

Cited by 25 publications

(16 citation statements)

References 24 publications

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“…22 Shehadeh-Mashor et al reported that pterygium excision and conjunctival autograft using fibrin glue to secure the graft combined with intraoperative mitomycine C seems to be a safe and effective surgical option for treating recurrent pterygium. 23 When the two components of the fibrin glue are applied simultaneously, a fibrin clot forms within approximately 30 seconds. 11 Therefore, there is limited time for positioning of the graft.…”

Section: Discussionmentioning

confidence: 99%

The Use of Fibrin Glue in Primary and Recurrent Pterygium Surgery

Çetinkaya¹,

Cetinkaya²,

Gürdağ³

et al. 2016

Turkiye Klinikleri J Ophthalmol

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Section: Discussionmentioning

confidence: 99%

The Use of Fibrin Glue in Primary and Recurrent Pterygium Surgery

Çetinkaya¹,

Cetinkaya²,

Gürdağ³

et al. 2016

Turkiye Klinikleri J Ophthalmol

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“…These drawbacks include the requirement for a more extensive or general anesthesia, a longer operating time of about 2 hours, the need for a skilled assistant, poor immediate postoperative cosmesis, and a relatively prolonged postoperative diplopia and pain. MMC in the treatment of recurrent pterygia has been more commonly used as an intraoperative topical application 2,8. Preoperative subconjunctival injections of MMC are usually given from a day up to a month prior to surgery, and intraoperative tissue grafting to cover the bare sclera after pterygium excision is usually not necessary 9.…”

Section: Discussionmentioning

confidence: 99%

Pre- and intraoperative mitomycin C for recurrent pterygium associated with symblepharon

Mohammed¹

2013

OPTH

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BackgroundTreatment of recurrent pterygium associated with symblepharon usually involves the use of tissue grafting and/or the intraoperative application of mitomycin C (MMC). For the graft, a conjunctival/limbal autograft and/or amniotic membrane may be used. This generally requires extra technical skills and assistance, an increase in the cost and duration of surgery, and a more extensive anesthesia (a complete eye block or general anesthesia). Although widely used, safety concerns have been raised over MMC in the treatment of pterygia.ObjectiveThe objective of this case report is to report the successful use of preoperative subconjunctival injection of low-dose (0.02%) MMC one month before bare sclera excision of a multirecurrent pterygium, as well as the concomitant intraoperative application of MMC to the conjunctival fornix of the same eye after the excision of an associated symblepharon.Case reportA 31-year-old man from Kano, Northern Nigeria, presented to the eye clinic with a recurrent pterygium associated with an upper lid symblepharon in his right eye. He has had five previous pterygium excisions, with the last surgery involving conjunctival autografting and subconjunctival steroid injection. He was subsequently given 0.1 mL of 0.02% MMC as a subpterygial injection; one month later he had an alcohol-assisted bare sclera pterygium excision and a symblepharolysis with the intraoperative application of 0.02% MMC for 1 minute to the upper conjunctival fornix. Except for a Tenon granuloma that was simply excised, there has been no recurrence or other complications up to a year after surgery.ConclusionAs a cheaper and technically easier treatment option, a preoperative subconjunctival MMC injection followed by bare sclera pterygium excision was found to be effective in this patient with a recurrent pterygium. As at one-year follow-up, low-dose preoperative MMC a month prior to surgery also appeared safe and effective when combined with its intraoperative application to the conjunctival fornix for the treatment of associated symblepharon.

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“…25 Bir diğer seride, yirmi sekiz nüks pterjiyum olgusunda bir yıllık takip sonunda mitomisin C ile birlikte LKOT sonrası nüks oranı, 4% olarak bulunmuştur. 26 Luanratanakorn ve ark. 27 altı aylık takip sonunda, on dört göze uyguladıkları LKOT sonrası %21, on dokuz gözde uyguladıkları AMGT sonrası %53'lük nüks oranı yayınlamışlardır.…”

Section: Discussionunclassified

NüksPterjiyumdaLimbalKonjonktival Otogreft Tekniği

Özer¹,

Erol²,

Gürsoy³

et al. 2013

Tjo

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ÖzetAmaç: Primer pterjiyum için farklı cerrahi teknikler sonrası gelişen nüks pterjiyumlarda, limbal konjonktival otogreft tekniği (LKOT) sonuçlarımızı sunmak. Ge reç ve Yön tem: Bu çalışmada nüks pterjiyum tedavisinde LKOT uygulanan olgular retrospektif olarak incelendi. Olgular primer uygulanan pterjiyum cerrahisi türüne göre üçe ayrıldı. Grup 1 çıplak sklera yöntemi, grup 2 LKOT ve grup 3 amniyotik membran greft tekniği sonrasında nüks pterjiyum gelişmiş olgulardı. Gruplar kornea epitelizasyonu, nüks ve cerrahi sonrası komplikasyonlar açısından karşılaştırıldı. Sonuçlar: Kırk iki hastanın 42 gözü incelendi. Ondokuz hastanın 19 gözü grup 1'i, 11 hastanın 11 gözü grup 2'yi ve 12 hastanın 12 gözü grup 3'ü oluşturdu. Yaş ortalaması grup 1'de 45,38±12,22 (24-72), grup 2'de 46,81±13,41 (25-73) ve grup 3'de 44,83±11,92 (27-66) yıldı. Takip süresi grup 1'de 19,38±6,03 (9-32), grup 2'de 21,37±7,41 (11-34) ve grup 3'de 20,93±7,26 (10-34) aydı. Cerrahi sonrası kornea epitelizasyonu grup 1'de 5,62±1,74 (2-7), grup 2'de 4.33±0.91 (2-7) ve grup 3'te 4,79±1,39 (2-7) günde tamamlandı (p=0,035). Nüks grup 1'de 4 gözde (%21), grup 2'de 3 gözde (% 27) ve 3. grupta 3 gözde (% 25) saptandı (p=0,092). Ameliyat sonrası komplikasyon grupların hiçbirinde görülmedi. Tar t›fl ma: LKOT yüksek başarı ve düşük nüks oranları nedeniyle primer cerrahiden bağımsız olarak, tüm nüks pterjiumların cerrahisinde etkili bir tedavi olarak görünmektedir. LKOT uygulanan olgulardaki düşük nüks oranı konjonktival greftle pterjiyum eksizyon bölgesine nakledildiği düşünülen limbal kök hücreleri ile ilişkili olabilir. LKOT sonrası nükslerde daha erken korneal epitelizasyon görülmesi önceki ameliyatta nakledildiği düşünülen bu hücrelerinin aktivasyonlarını belli bir ölçüde de olsa devam ettirdiklerinin göstergesi olabilir. (Turk J Ophthalmol 2013; 43: 241-4) Anah tar Ke li me ler: Pterjiyum, nüks pterjiyum, limbal konjonktival otogreft, çıplak sklera, amniyon zarı Sum maryPur po se: To present our results of limbal conjunctival autograft technique (LCAT) for recurrent pterygium which developed after different surgical techniques for primary pterygium. Ma te ri al and Met hod: Cases, who underwent LCAT for the treatment of recurrent pterygium, were evaluated. The cases were divided into three groups based on the primary surgery performed. Recurrent pterygium developed after bare sclera technique in group 1, LCAT in group 2, and amniotic membrane graft technique in group 3. Corneal epithelization, recurrence rate, and postoperative complications were compared among groups. Re sults: Forty-two eyes of 42 patients were evaluated. Nineteen eyes of 19 patients formed group 1, 11 eyes of 11 patients -group 2, and 12 eyes of 12 patients -group 3. Mean age (years) was 45.38±12.22 (24-72) in group 1, 46.81±13.41 (25-73) in group 2, and 44.83±11.92 (27-66) in group 3. Follow-up (months) was 19.38±6.03 (9-32) in group 1, 21. 37±7.41 (11-34) in group 2, and 20.93±7.26 (10-34) in group 3. Postoperative corneal epithelization was completed after 5.62±1.74 (2-7) days in gr...

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Management of Recurrent Pterygium With Intraoperative Mitomycin C and Conjunctival Autograft With Fibrin Glue

Cited by 25 publications

References 24 publications

The Use of Fibrin Glue in Primary and Recurrent Pterygium Surgery

The Use of Fibrin Glue in Primary and Recurrent Pterygium Surgery

Pre- and intraoperative mitomycin C for recurrent pterygium associated with symblepharon

NüksPterjiyumdaLimbalKonjonktival Otogreft Tekniği

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