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

Miriam Idoipe,Luis Pablo,Eduardo Anitua,Gorka Orive,Carmen Sánchez-Pérez,María Satué,Francisco Muruzabal,Antonio Sánchez-Pérez,Borja De La Sen-Corcuera,Ronald M Sánchez-Ávila

doi:10.3390/jcm10235711

Abstract

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.

Highlights

Pterygium is defined as a fibrovascular formation of triangular morphology that extends from the conjunctiva to the cornea [1]
This study aims to provide information about the safety and efficacy of mPRGF as a graft for pterygium surgery, compared with conjunctival autograft (CAG) and amniotic membrane (AM) grafts
Surgical techniques for pterygium treatment have been improved over the years; nowadays, it is necessary to achieve the closure of the tissue defect, avoid recurrence, improve symptoms of the ocular surface, and increase life quality of patients [8,13,14]

Summary

Introduction

Pterygium is defined as a fibrovascular formation of triangular morphology that extends from the conjunctiva to the cornea [1]. This neoformation is more frequent in the nasal sector [1], and it is characterized by inflammation and fibrosis, leading to tissue remodeling [2]. It affects the conjunctival collagen, leading to elastotic degeneration; Bowmans membrane and corneal surface destruction are observed along with stem cell alterations [2]. Nolan et al [4]

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