[Modified mini-SLET for treatment of complex cases in pterygium surgery].

Abstract

The major problem associated with the benign but destructive growing pterygium is the high recurrence rate. Anew surgical technique to lower recurrence rates is minor ipsilateral simple limbal epithelial transplantation (mini-SLET), where the regeneration potential of limbal stem cells is used in combination with amniotic membrane transplantation (AMT) for surgical reconstruction. The aim of this study is to assess the surgical outcome of the mini-SLET technique with tenonectomy, mitomycinC, and AMT as used in the authors' hospital. Atotal of 16eyes from 15patients undergoing mini-SLET after surgical pterygium removal with tenonectomy, mitomycinC, and AMT were analyzed retrospectively. Two different groups of pterygia were enrolled: group1 included recurrent pterygia (n = 10) and group2 comprised primary large pterygia such as double-head pterygia (n = 6). In addition to assessment of best corrected visual acuity and compete ophthalmological examination, preoperative slip-lamp examination with photo documentation served to calculate the corneal size of the pterygium head using VISUPAC software (Zeiss, Oberkochen, Germany). Postoperatively, best corrected visual acuity and slit-lamp examination were routinely evaluated. The surgical outcome was defined by the postoperatively achieved best corrected visual acuity, restoration of the ocular surface, recurrence rate, and rate of postoperative complications. Median follow-up in all patients was 27months; in groups1 and 2 it was 30.7and 25.3months, respectively. No recurrence developed in 15eyes (93.75%). Only one group1 patient (6.25%) suffered arecurrent lesion after 10months. Postoperatively, logMAR visual acuity did not change significantly. During follow-up, complications were limited to one case of early wound dehiscence. Mini-SLET in combination with tenonectomy, mitomycinC, and AMT enables good surgical reconstruction of the ocular surface, and almost complete healing in the sense of restitutio ad integrum is possible. The results of the present study have shown the technique's effectiveness for recurrence prevention.