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

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.

scholarly journals Amniotic Membrane Transplantation in the Treatment of Primary Pterygium: A Comparative Study of Two Techniques

2014 ◽  
Vol 48 (1) ◽  
pp. 1-7
Author(s):  
Reema Bansal ◽  
R Sehgal
Keyword(s):  
Comparative Study ◽  
Amniotic Membrane ◽  
Free Edge ◽  
Amniotic Membrane Transplantation ◽  
Human Amniotic Membrane ◽  
Purse String ◽  
Group A ◽  
End To End ◽  
Group B ◽  
Primary Pterygium

ABSTRACT Purpose To compare two techniques of human amniotic membrane transplantation (AMT) following pterygium excision: (1) end to end suturing of the amniotic membrane graft (AMG) with the conjunctiva versus (2) a new technique of purse-string suturing of the AMG and tucking of AMG under the free edge of conjunctiva. Materials and methods Pterygium surgery with human AMT was done in 42 eyes with primary pterygium. Twenty four eyes (group A) underwent end-to-end suturing of AMG with conjunctiva. Eighteen eyes (group B) underwent purse-string suturing of AMG with underlying sclera with free edge of AMG tucked under conjunctiva on three sides. The two groups were compared in terms of the outcome measures, i.e. complete epithelialization time of AMG and recurrence of pterygium within 1 year. Results The complete epithelialization of AMG occurred in 21 days (range 14 to 28 days) and 14 days (range 7 to 21 days) in groups A and B respectively. In group A, 7 eyes (29.17%) developed recurrence. In group B, 2 eyes (11.11%) developed recurrence. Conclusion Purse string suturing and tucking of AMG resulted in faster epithelization of AMG and lower recurrences in comparison with end to end suturing of AMG in the management of primary pterygium. How to cite this article Bansal R, Jain AK, Sehgal R. Amniotic Membrane Transplantation in the Treatment of Primary Pterygium: A Comparative Study of Two Techniques. J Postgrad Med Edu Res 2014;48(1):1-7.

scholarly journals Limbal-conjunctival Autograft Transplantation Versus Conjunctival Autograft Transplantation In The Treatment Of Pterygium: A Self-control Study

2019 ◽  
Author(s):  
Tianyu Wang ◽  
Yifan Gu ◽  
Yi Zhang ◽  
Lu Pan
Keyword(s):  
Recurrence Rate ◽  
Healing Time ◽  
Corneal Epithelial ◽  
Conjunctival Autograft ◽  
Surgical Methods ◽  
Group A ◽  
Group B ◽  
Epithelial Healing ◽  
Limbal Conjunctival Autograft ◽  
Primary Pterygium

Abstract Background : Pterygium is a common ocular growth, which affects vision, ocular surface function, and aesthetics of the eye. Although various surgical methods are used for treating pterygium, there has been no consensus on the most suitable method. Therefore, it is important to choose the most appropriate and effective surgical method for the treatment of pterygium. The aim of this study was to compare the characteristics and efficacy of limbal-conjunctical autograft transplantation and conjunctival autograft transplantation for the treatment of pterygium. Methods : From August 2015 to December 2016, 80 patients with bilateral primary pterygium in Minhang Hospital affiliated to Fudan University were treated with limbal-conjunctival autograft transplantation in one eye (group A) and conjunctival autograft transplantation in the fellow eye (group B). The operative times of the two surgical methods were compared. The corneal epithelial healing times and recurrence rates for the two methods were observed and recorded after two years of follow-up. Results : Eight patients dropped out of the study and 72 patients participated in the final evaluation. The average operative time for group A and group B was 27.56 1.48 minutes and 26.91 1.39 minutes, respectively. There was no significant difference between the operative times for the two groups (t = 1.93, P = 0.058). The average corneal epithelial healing time for groups A and B was 2.56 0.34 days and 4.85 0.49 days, respectively (t=25.26, P < 0.001). Two years after the surgery, pterygium recurred in two eyes (2.78%) in group A and in nine eyes (14.29%) in group B. The difference between the two groups was statistically significant (2=4.82, P=0.028). Conclusion : In primary pterygium surgery, the healing time of the corneal epithelium after limbal-conjunctival autograft transplantation is shorter than that after conjunctival autograft transplantation, and the pterygium recurrence rate after limbal-conjunctival autograft transplantation is lower than that after autologous conjunctival transplantation. Although both limbal-conjunctival autograft transplantation and conjunctival autograft transplantation can achieve good clinical results, limbal-conjunctival autograft transplantation is superior to conjunctival autograft transplantation in terms of the corneal epithelial healing time and recurrence rate of pterygium after surgery.

scholarly journals Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study

2021 ◽  
Vol 14 (1) ◽  
pp. 82-87
Author(s):  
Khalil M. Al-Salem ◽  
Ahmad T.S. Saif ◽  
Passant S. Saif
Keyword(s):  
Postoperative Complications ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
University Hospital ◽  
Beta Radiation ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Excision ◽  
Group B ◽  
Primary Pterygium

Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

Comparison among adjuvant treatments for primary pterygium: a network meta-analysis

2017 ◽  
Vol 102 (6) ◽  
pp. 748-756 ◽  
Author(s):  
Ellen Carrara Fonseca ◽  
Eduardo Melani Rocha ◽  
Gustavo Viani Arruda
Keyword(s):  
Single Dose ◽  
Latin American ◽  
Meta Analysis ◽  
Indirect Comparison ◽  
Amniotic Membrane Transplantation ◽  
Surgical Removal ◽  
Eye Drops ◽  
Conjunctival Autograft ◽  
Pterygium Surgery ◽  
Primary Pterygium

PurposePterygium is a frequent ocular disease, where the major challenge is the high level of recurrence after its surgical removal. We performed a network meta-analysis to identify, among several adjuvant treatments for primary pterygium, which is the best to prevent recurrence.MethodsA search was conducted using PubMed, Scientific Electronic Library Online, Latin American and Caribbean Centre on Health Sciences and Cochrane Eyes and Vision Group Trials Register between 1993 and 2015 for randomisedclinical trials (RCTs) comparing adjuvant treatments following primary pterygium surgery.Results24 RCTs that studied 1815 eyes of 1668 patients were included and allowed direct and indirect comparison among 14 interventions through network meta-analysis. The rank from the best to worse treatment to prevent recurrence is: conjunctival autograft + ciclosporin 0.05% eye drops, bare sclera + intraoperativemitomycin C (MMC) <0.02%, bare sclera + beta therapy (2500 cGy single dose), conjunctival autograft + beta therapy (1000 cGy single dose), bare sclera + MMC 0.02% eye drops, conjunctival autograft, bare sclera + intraoperative MMC >0.02%, bare sclera + ciclosporin 0.05% eye drops, bare sclera + intraoperative 5-fluorouracil 5%, amniotic membrane transplantation, bare sclera + intraoperative MMC 0.02%, conjunctival autograft + bevacizumab 0.05% eye drops, bare sclera + bevacizumab 0.05% eye drops and bare sclera alone.ConclusionThe best adjuvant treatment to prevent recurrence after primary pterygium surgery is the association of conjunctival autograft and ciclosporin 0.05% eye drops. Bare sclera technique alone should be discontinued since it is associated with high recurrence rates.

scholarly journals Non-Recurrence Complications of Fibrin Glue Use in Pterygium Surgery: Prevention and Management

2015 ◽  
Vol 9 (1) ◽  
pp. 159-163 ◽  
Author(s):  
Halil Hüseyin Cagatay ◽  
Gökçen Gökçe ◽  
Alper Mete ◽  
Yaran Koban ◽  
Metin Ekinci
Keyword(s):  
Fibrin Glue ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Management Strategies ◽  
Cyst Formation ◽  
Amniotic Membrane Transplantation ◽  
Topical Steroids ◽  
Graft Removal ◽  
Pterygium Surgery ◽  
Pterygium Excision

Purpose : To present complications of using fibrin glue in conjunctival-limbal autografting in pterygium surgeries other than recurrences and discuss their prevention and management strategies. Materials and Methodology: The charts of all patients who underwent fibrin glue assisted pterygium excision surgery with conjunctival-limbal autograft transplantation from 2010 to 2013 were reviewed. Patients who developed complications except recurrence postoperatively were included in this study. Results : Sixteen (17.39%) of the 92 patients were detected with a complication. Graft dehiscence was diagnosed in 7 (7.6%) patients with 5 of them treated conservatively and 2 patients requiring suturing. Five (5.43%) patients were diagnosed with cyst formation between the graft and conjunctiva or in the graft-removal area; these cysts were primarily excised and no additional problems occurred. Corneal dellen developed in 3 (3.26%) patients and 2 of them regressed after cessation of topical steroids and application of lubricant therapy while one was treated with amniotic membrane transplantation. Residual fibrin glue particles had stiffened on the ocular surface, which resulted in intensive pain and irritation in one (1.08%) patient on the same day of the surgery. The patient’s complaints were reduced by removing these particles from the ocular surface under topical anesthesia. Conclusion : Complications in fibrin glue assisted pterygium surgery are relatively different from other techniques. To avoid potential complications of fibrin glue in pterygium surgery, peroperatively ophthalmologists should ensure the conjunctival autograft and conjunctiva are properly adhered, fibrin glue remnants are completely removed from the ocular surface, and no Tenon’s capsule remains between the graft and the conjunctiva.

Comparison of Conjunctival Autograft With Amniotic Membrane Transplantation for Pterygium Surgery

Cornea ◽  
2007 ◽  
Vol 26 (4) ◽  
pp. 407-413 ◽  
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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