Postoperative Conjunctival Inflammation After Pterygium Surgery With Amniotic Membrane Transplantation Versus Conjunctival Autograft

BACKGROUND Minimizing inflammation on the ocular surface after pterygium surgery is essential to prevent recurrence. Currently, limited data are available for the comparison between freeze-dried amniotic membrane (FD-AM) and conjunctival–limbal graft (CLG). Therefore, this study aimed to assess conjunctival inflammation and the interleukin (IL)-6 levels in tears after pterygium excision between both techniques. METHODS This prospective, single-blinded, randomized clinical trial included 26 eyes of 26 patients with primary or recurrent pterygium and who were indicated for pterygium surgery at Cipto Mangunkusumo Hospital, Indonesia from October 2017 until February 2018. The patients were scheduled for pterygium excision with FD-AM or CLG based on block randomization. Conjunctival inflammation and the level of IL-6 in tears were measured on day-7 and -28 after surgery. RESULTS The 26 eyes (13 in each group) were subjected to a complete 1-month follow-up period. Day-7 after the surgery, severe inflammation occurred in 4/13 (31%) eyes having FD-AM and 8/13 eyes (62%) having CLG (p = 0.59). The IL-6 tear level increased similarly in FD-AM (22.85 pg/ml) and CLG (23.51 pg/ml) in (p = 0.78). No severe adverse events occurred. CONCLUSIONS Pterygium excision using FD-AM yield a milder inflammation than CLG on day-7 and -28 after surgery. The tear IL-6 levels similarly increased on day-7.

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Comparison of Conjunctival Autograft With Amniotic Membrane Transplantation for Pterygium Surgery

Cornea ◽

10.1097/ico.0b013e318033b3d4 ◽

2007 ◽

Vol 26 (4) ◽

pp. 407-413 ◽

Cited By ~ 44

Author(s):

Cem Küçükerdönmez ◽

Yonca A Akova ◽

Dilek Dursun Altnörs

Keyword(s):

Amniotic Membrane ◽

Amniotic Membrane Transplantation ◽

Conjunctival Autograft ◽

Pterygium Surgery

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Membrane of Plasma Rich in Growth Factors in Primary Pterygium Surgery Compared to Amniotic Membrane Transplantation and Conjunctival Autograft

Journal of Clinical Medicine ◽

10.3390/jcm10235711 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5711

Author(s):

Miriam Idoipe ◽

Borja de la Sen-Corcuera ◽

Ronald M. Sánchez-Ávila ◽

Carmen Sánchez-Pérez ◽

María Satué ◽

...

Keyword(s):

Growth Factors ◽

Amniotic Membrane ◽

Ocular Surface ◽

Amniotic Membrane Transplantation ◽

Graft Size ◽

Conjunctival Autograft ◽

Group A ◽

Pterygium Surgery ◽

Group B ◽

Primary Pterygium

This prospective and comparative study aimed to compare the use of a conjunctival autograft (CAG), plasma rich in growth factors fibrin membrane (mPRGF) or amniotic membrane transplantation (AMT) in primary pterygium surgery. Patients were assigned for surgery with CAG (group A), mPRGF (group B), or AMT (group C). Pterygium recurrence, Best Corrected Visual Acuity (BCVA), graft size (measured with anterior segment optical coherence tomography (AS-OCT)), and ocular surface symptoms (visual analogue scale (VAS) and ocular surface disease index (OSDI)) were evaluated. Thirteen eyes in group A, 26 in group B, and 10 in group C were evaluated. No changes in BCVA (p > 0.05) were found. Recurrence cases for groups A, B, and C were none, two, and two, respectively, and three cases of pyogenic granulomas in group A. The horizontal/vertical graft size was lower in group B vs group A (p < 0.05) from months 1 to 12. The improvement in VAS frequency for groups A, B, and C was: 35.5%, 86.2%, and 39.1%, respectively. The OSDI scale reduction for groups A, B, and C was: 12.7%, 39.0%, and 84.1%. The use of the three surgical techniques as a graft for primary pterygium surgery was safe and effective, showing similar results. The mPRGF graft represents an autologous novel approach for pterygium surgery.

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Comparison of free conjunctival autograft versus amniotic membrane transplantation for pterygium surgery

Journal of Current Ophthalmology ◽

10.1016/j.joco.2017.08.003 ◽

2017 ◽

Vol 29 (4) ◽

pp. 282-286 ◽

Cited By ~ 4

Author(s):

Mitra Akbari ◽

Reza Soltani-Moghadam ◽

Ramin Elmi ◽

Ehsan Kazemnejad

Keyword(s):

Amniotic Membrane ◽

Amniotic Membrane Transplantation ◽

Conjunctival Autograft ◽

Pterygium Surgery

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Two case reports of continued progression of chronic ocular graft-versus-host disease without concurrent systemic comorbidities treated by amniotic membrane transplantation

BMC Ophthalmology ◽

10.1186/s12886-021-01925-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hideto Ikarashi ◽

Naohiko Aketa ◽

Eisuke Shimizu ◽

Yoji Takano ◽

Tetsuya Kawakita ◽

...

Keyword(s):

Graft Versus Host Disease ◽

Amniotic Membrane ◽

Case Reports ◽

Signs And Symptoms ◽

Amniotic Membrane Transplantation ◽

Team Approach ◽

Host Disease ◽

Graft Versus Host ◽

Target Organs ◽

Conjunctival Inflammation

Abstract Background Chronic ocular graft-versus-host disease (oGVHD) is an ocular comorbidity of graft-versus-host disease (GVHD) that usually occurs concurrently with systemic manifestations. Failure to detect and treat oGVHD in its early stages may lead to progression of ocular signs and symptoms leading to oGVHD that is refractory to conventional treatment. Case presentation We report the clinical course of a 19-year-old male and a 59-year-old female with severe and progressive chronic oGVHD without concurrent systemic signs of chronic graft-versus-host disease (cGVHD). Although their systemic conditions had been stable, both suffered from severe oGVHD and were referred to our clinic. Both cases exhibited marked improvement in conjunctival inflammation and fibrotic changes after amniotic membrane transplantation (AMT). Both cases underwent keratoplasty eventually to stabilize ocular surface conditions and to improve visual function. Conclusions We reported the clinical outcomes of 2 cases of chronic oGVHD without concurrent systemic comorbidities that were treated with AMT. The clinician should be aware that cGVHD may persist in target organs even in the absence of concurrent systemic comorbidities following seemingly successful systemic treatment. A multidisciplinary team approach is essential in the early detection and therapeutic intervention for chronic oGVHD.

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