Sutureless amniotic membrane transplantation combined with narrow-strip conjunctival autograft for pterygium

Abstract

To study the efficacy and safety of sutureless amniotic membrane transplantation combined with narrow-strip conjunctival autograft and to investigate the clinical outcomes. Thirty eyes of 30 patients with primary pterygia were treated in this institutional study with excision followed by sutureless amniotic membrane transplantation combined with narrow-strip conjunctival autograft using fibrin glue tissue adhesive. The main outcome measures were the operating time for ocular surface reconstruction, the size of the pterygium and of the conjunctival autograft, postoperative complications, subjective complaints, and recurrences. The mean pterygium size was 3.12 ± 0.92 mm and the mean operating time was 4.58 ± 1.10 min. Twenty-nine patients (96.7%) had no complaints after first postoperative week. Twenty-eight (93.3%) patients had no recurrences after 1 year follow-up. The sutureless amniotic membrane transplantation combined with narrow-strip conjunctival autograft is an effective procedure with low rate of recurrence. This technique can be considered as a preferred grafting procedure for primary pterygium but further randomized controlled studies including larger populations are needed.

Advancing biomaterials of human origin for tissue engineering

“…When serving as an adjunctive therapy after primary pterygium excision, AM grafts have been demonstrated to be as effective as standard conjunctival autografts in preventing pterygium recurrence [148]. Moreover, as an effective procedure with a low rate of recurrence, sutureless human AM transplantation combined with a narrow-strip conjunctival autograft is considered as a preferred grafting strategy for primary pterygium, although further randomized controlled trials involving larger populations remain to be performed [149]. Additionally, to use this human material as an advanced biomedical product containing viable stem cells and bio-logics for reconstructive surgery, much more work remains to be conducted to shed light on the influences of tissue culture and/or cryopreservation conditions on cell viability, to identify easy and practical processes to store human AM containing robust cells and to verify the quality of the tissue transferred before its clinical application [143].…”

Molecular Basis of Pterygium Development

“…161,162 However, there are controversial results regarding the effectiveness of this method in preventing pterygium recurrence when compared with conjunctival autografts. [163][164][165][166][167] Autologous nasal mucosa transplantation has proven to be effective for ocular surface reconstruction in chemical burn-damaged corneas. 168 This procedure could be used for the treatment of conjunctiva-deficient or severely damaged pterygia.…”

The results of conjunctivolimbal autograft transplantation in primary pterygium

“…Ancak %24-89 gibi yüksek nüks oranları nedeniyle alternatif cerrahi yöntemler geliştirilmiştir [14]. Günümüzde çeşit-li modifiye cerrahi yöntemler (amniotik membran transplantasyonu, konjonktival otogreft transplantasyonu, konjonktivalimbal otogreft transplantasyonu) ve adjuvan ajanlar (mitomisin-C, 5-florourasil, thio-tepa ve beta radyasyon) kullanılmaya başlan-mıştır [9,10].…”

“…Uzun yıllar uygulanan çıplak sklera ve primer konjonktiva kapatılma-sında oldukça yüksek nüks oranlarına rastlanmıştır [2]. Nüks oranlarını azaltmaya yönelik çeşitli modifiye cerrahi yöntemler kullanılmaya başlanmıştır [9,10]. Bu yöntemlerden konjonktivalimbal otogreft transplantasyonu, pterjium nüks oranlarının (%2-9) ve komplikasyon oluşumunun azaltılmasında en etkili yöntem olarak bildirilmiştir [11,12].…”