Pterygium surgery by means of conjunctival autograft: long term follow-up

Abstract

Purpose: To demonstrate the long term of follow-up of the recurrence rate after conjunctival autograft for pterygium surgery. Methods: A total of 112 patients operated for pterygium with conjunctival autografts and with more than one year follow-up were registered. Patients were called for voluntary examinations of their respective ocular surface statuses. Completing the study was only possible in 44 cases. Seven had bilateral pterygium. (N=51 operated pterygium). Results:The mean follow-up time was 49.06 months. In 29.45% of the cases, attachment was performed using non-absorbable sutures (nylon 10/0), while fibrin glue was used in 70.55% of the cases. Six cases of recurrence (11.76%) were found. The recurrence rate between primary and recurrent pterygium, and between sutures and fibrin glue proved to be not statistically significant; p>0.05. There were no significant differences between women and men with respect to recurrence. The median of age in the recurrence group was 40 years old, in contrast to 55 in the non-recurrence group; p=0.01517. All of these recurrences were associated with patients of Hispanic origins (from Latin America); p=0.001506. Conclusions: After a long follow-up period after autograft pterygium surgery, there were no statistically significant differences in recurrence rates for the application of sutures as opposed to fibrin glue; similarly, there were no statistically significant differences between the use of autograft in primary and recurrent pterygium. The greatest risk factors for recurrence were young age and Hispanic ethnicity.Keywords: Pterigium/surgery; Transplantation, autologous; Conjunctiva/transplantation, Sutures; Fibrin tissue adhesive RESUMO Objetivo: Demonstrar a taxa de recorrência em cirurgia do pterígio com transplante autólogo de conjuntiva após um acompanhamento a longo prazo. Métodos: Cento e doze pacientes operados de pterígio e transplante autólogo de conjuntiva, com mais de um ano de acompanhamento foram registrados. Os pacientes foram chamados para um exame voluntário de estado da superfície ocular. O estudo completo só foi possível em 44 pacientes. Sete deles tinha tido pterígio bilateral. (N=51). Resultados: A média de acompanhamento a partir do momento da cirurgia até o exame foi de 49,06 meses. A sutura não-absorvível (nylon 10/0) foi usada em 29,45% dos casos, enquanto que a cola biológica de fibrina foi usada em 70,55%. A recidiva do pterígio foi detectada apenas em 6 casos (11,76%). As recidivas entre pacientes operados de pterígio primário e recorrente, e entre o uso de suturas ou cola de fibrina não foram significativos (p>0,05). Também não houve diferença significativa na recorrência com relação ao sexo. A idade média no grupo de recidiva foi de 40 anos e no grupo sem recidiva de 55 anos (p=0,01517). Todas essas recorrências ocorreram em pacientes de origem hispânica (América latina) (p=0,001506). Conclusões: A longo prazo da remoção cirúrgica de pterígio utilizando um transplante autólogo de conjuntiva, não há diferença estatisticamente sig...

Prevalence of pterygium and outcome of pterygium surgery in hilly western Nepal

“…However, other studies showed male preponderance eg. Fernandes et al [5] (53.9%), Heurva et al [11] (64%), and Paracha et al [12] (64%).…”

The Variation in Surgical Technique and Role of Physician Experience in Pterygium Surgical Outcomes

“…If this holds true, the attendings' recurrence rates may trend higher due to more difficult procedures and higher risk of recurrence. Younger age also increases the risk for recurrence, but age was not significantly different between the experience groups [25,[28][29][30].…”

Surgical Reconstruction of Ocular Surface Tumors Using Fibrin Sealant Tissue Adhesive

“…Fibrin tissue adhesive has been widely applied in various medical fields, including ophthalmic surgery such as vitreoretinal, glaucoma, ocular surface, cataract and refractive surgery [3,4,5,6,7,8,9,13,14,15,16,17,18]. To our knowledge, this is one of a few reports concerning the applicability of bioadhesive in ocular surface tumor surgery [5,15].…”

“…Bioadhesives have the advantage of faster surgical procedure, absence of friction and tension applied to the tissues, uniform adhesion between the handled structures, more comfort, less inflammation and lower risk of tissue necrosis, infections and pyogenic granuloma formation [4,7,13,17,18]. However, its application requires speed and skill of the surgeon, due to the rapid precipitation of its components [4,8,13,18].…”