Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium

Abstract

Aim: To compare the efficacy and complications of conjunctival limbal autograft (CLAU) and amniotic membrane transplantation (AMT) vs intraoperative mitomycin C (MMC) and AMT for treatment of recurrent pterygium. Methods: Forty eyes of 40 patients with recurrent pterygium underwent CLAU and AMT (20 eyes) or intraoperative MMC (0.02%, 3 min) and AMT (20 eyes). Three eyes (15%) had symblepharon before surgery in each group. Recurrence was compared in each group by using v 2 test. Results: No major postoperative complications occurred during 6-19 months of follow-up. In CLAU/AMT group, no pterygium recurrence was observed. Recurrence occurred in four eyes (20%) in MMC/AMT group after 3 and 4 months (P-value ¼ 0.035, v 2 test). No recurrence of pterygium or symblepharon was seen in six eyes with recurrent pterygium and symblepharon (three eyes in each group). Conclusion: CLAU with AMT seems to be more effective than intraoperative MMC with AMT for treatment of recurrent pterygium.

Efficacy and Safety of Limbal-Conjunctival Autografting with Limbal Fixation Sutures after Pterygium Excision

“…This is comparable to the results of previous studies, which have demonstrated the efficacy of limbal-conjunctival free grafts in reducing the recurrence rate (1.9–14.3%) [9,10,11,12,16,17,18,19]. In particular, no recurrence was reported in 21 eyes with recurrent pterygium, which supports the speculation that limbal autografts should be recommended for treatment of recurrent pterygia [3,11,19,20]. In a prospective clinical trial, Chen et al [21] reported that only 6% of recurrences were observed after the 6th postoperative month, suggesting that most recurrences occurred during the early postoperative period.…”

“…This condition causes cosmetic problems and occasional visual disturbance, and successful surgical treatment continues to be a challenge due to a high recurrence rate, especially in patients treated with the bare-sclera technique [1,2,3,4]. …”

Spectral domain anterior segment optical coherence tomography assessment of pterygium and pinguecula

“…It is well known that a recurrent pterygium is more difficult to control, and various treatment modalities have been proposed (Fallah et al 2008;Hirst 2009). Using SD-OCT for the evaluation of recurrent pterygium in this study, we were able to show that the tongue-like mass of the pterygium was more advanced beneath the corneal epithelium, a view that may explain the difficulty of managing and the high incidence of repeated recurrences after recurrent pterygium surgery.…”

Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis

“…Fifteen potentially relevant studies were identified [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Ten studies [16][17][18][19][20][21][22][23][24][25] were excluded from further analysis: two were excluded because they were not relevant [16,17], two were excluded because combined surgical modalities for patients were used [18,19], and six were excluded because there was insufficient information for calculating lnHR or var(lnHR) [20][21][22][23][24][25].…”

“…Ten studies [16][17][18][19][20][21][22][23][24][25] were excluded from further analysis: two were excluded because they were not relevant [16,17], two were excluded because combined surgical modalities for patients were used [18,19], and six were excluded because there was insufficient information for calculating lnHR or var(lnHR) [20][21][22][23][24][25]. A total of five studies remained eligible for pooling risk estimates [11][12][13][14][15].…”