Conjunctival Autograft Transplantation Research Articles

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note.

To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation. Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability. Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence. ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.

A prospective comparative study of conjunctival autograft (CAG) with dry amniotic membrane graft (AMG) transplantation in pterygium excision surgery

: Pterygium is a wing-shaped, fibrovascular proliferation of the bulbar conjunctiva which crosses the limbus and causes encroachment over the cornea. It is mainly treated by surgical excision. Management options for pterygium include conjunctival autografting, and the use mitomycin C, amniotic membrane graft, 5-fluorouracil, anti-vascular endothelial growth factor (anti-VEGF) agents, and β-irradiation along with excision, to avoid recurrence.: To compare the efficacy and safety of conjunctival autograft (CAG) transplantation and dry amniotic membrane graft (AMG) transplantation in pterygium excision surgery.: Prospective comparative study.: The study was done on 43 eyes of 43 patients. CAG was transplanted on 23 patients &amp; dry AMG was transplanted on 20 patients. All patients were followed up on day 1, day 7, 1 month and 6 months post operatively. On each visit pterygium recurrence, graft retraction, necrosis and visual outcomes were noted from all the patients.: Fisher exact test.: 28(65%) were males while 15(35%) were females. Most of the patients were &amp;#60;40 years of age. During the follow up period, best corrected visual acuity of 3(7%) patients remained same and improved in 40(93%) patients. CAG group had 2(8.69%) while dry AMG group had 4(20%) recurrences (p value = 0.39, non-significant).: Although both the groups showed low recurrence rate but recurrence rate was more in dry AMG group as compared to conjunctival autograft group.: AMG is not always the best option for treating pterygium, but in some situations—such as those with extensive pterygium, conjunctival scarring etc.—it may be more advantageous for the patient.

Anterior Segment Optical Coherence Tomography Study of Pterygium in Conjunctival - Limbal Autograft Transplantation

&#x0D; Introduction: Progressive, gradual, non-malignant proliferation of fibro-vascular tissue, occurring due to repetitive limbal stem-cell irritation &amp; neovascularization, is referred to as pterygium. It is widespread in equatorial regions of the world, with a prevalence of 22% over a well defined ‘pterygium belt’. pterygium excision leaving bare sclera leads to the re occurrence, where as supplementing bare sclera with conjunctival autograft reduces the recurrence up-to 6%. Objective: Assessment of pterygium thickness pre-operative ly &amp; post-surgery keratectomy area along with graft thickness after conjunctival limbal autograft transplantation (CLAT) surgery by anterior segment optical coherence tomography (AS- OCT). Method: 50 patients with primary pterygium were distributed age wise in 4 groups of 20-39, 40-59, 60-79 &amp; 80-99 years. Anterior segment imaging was performed with RT-vue spectral domain AS-OCT. pterygium thickness pre-operatively &amp; keratectomy area along with autograft thickness after CLAT surgery was evaluated for a follow-up period of 3 months. Results: the pre-op pterygium &amp; 3 months post-op keratectomy area thickness at apex for (group 1) were 854um &amp; 573um, (group 2) were 855um &amp; 578um, (group 3) were 859um &amp; 574um and (group 4) were 868um &amp; 575um. Similarly at limbus for (group 1) are 1.13um &amp; 720um, for (group 2) are 1.14um &amp; 725um, for (group 3) are 1.19um &amp; 718um, for (group 4) are 1.24um &amp; 714um. Reduction in graft thickness in 3 months follow period for (group 1) was 311um, (group 2) 304um, (group3) 303um &amp; (group 4) 313um respectively. Conclusions: CLAT ascertains to be the ideal treatment modality for pterygium management in terms of decreasing the complications &amp; recurrence rate. Also, AS-OCT is the optimal investigating modality in assessment of pterygium before &amp; after CLAT surgery.

A COMPARATIVE STUDY TO EVALUATE THE CLINICAL OUTCOME OF CONJUNCTIVAL LIMBAL AUTOGRAFT AND AMNIOTIC MEMBRANE TRANSPLANT FOR THE TREATMENT OF PRIMARY PTERYGIUM

Aim: The aim of the study was to assess the safety and effectiveness of the conjunctival limbal autograft (CLAG) and amniotic membrane transplantation (AMT). Methods: After a full pre-operative assessment 100 patients with primary pterygium attending the ophthalmology outpatient department of a teaching hospital in Eastern India, fulfilling the inclusion and exclusion criteria were selected for our study. The patients were explained the procedure of the study and possible outcomes. They were divided into two groups. Group A: Where 10-0 nylon was to be used for CLAG after pterygium excision. Group B: Where 10-0 nylon was to be used for AMT after pterygium excision. Results: There was marked improvement in vision postoperatively more in the AMT group than CLAG. In the AMT group: 34% had a visual acuity of LogMAR 0.00, 30% had LogMAR 0.12, 12% had LogMAR 0.18, and 24% had LogMAR 0.30 after the surgery. In the CLAG group: 52% had a visual acuity of LogMAR, 20% had LogMAR 0.12, 22% had LogMAR 0.18, and 6% had LogMAR 0.30 after the surgery. Graft and suture-related complications were more in the CLAG group than in the amniotic membrane (AM) graft group. Conclusion: In the present study, The CLAG group was found to be associated with more discomfort, and more post-operative complications than AMT. AM may provide a basement membrane rich in various growth factors and matrix proteins, which promotes epithelial cell migration, adhesion, and differentiation. It is also believed to have anti-inflammatory and antifibrotic effects and exerts anti-scarring effects through the transforming growth factor-β pathway. AMT may be a superior treatment in primary pterygium due to lower recurrence rate, shorter surgical times, and better visual and cosmetic outcomes.

Outcomes of Fibrin Glue for Graft Fixation in Primary Pterygium Surgery with Conjunctival Autograft

Objective: To evaluate the recurrence rate and postoperative complications of fibrin glue fixation of conjunctival autografts following primary nasal pterygium excision. Materials and Methods: The present study was a retrospective study of all eyes with primary nasal pterygium that underwent pterygium excision with conjunctival autograft transplantation using fibrin glue for graft fixation at Mettapracharak (Wat Rai Khing) Hospital between July 2017 and December 2018. The author analyzed pterygium recurrence rates and postoperative complications such as graft loss, graft displacement or dehiscence, pyogenic granuloma, or any other complications. Results: Fifty-seven eyes of 57 patients were evaluated, of which 43 (75.4%) were female. The mean age was 57.09±1.38 years (range of 34 to 80 years). No serious complications occurred. One eye (1.8%) sustained recurrence in the six months follow-up. All grafts were intact. Graft displacement requiring suturing occurred in three cases (5%). Graft dehiscence was observed in 29.8%, and in all cases epithelialized without intervention. Other postoperative complications included pyogenic granuloma in 3.5%, graft edema, subgraft hemorrhage in 21.1%, and elevation of intraocular pressure over 21 mmHg in 5.3%. Conclusion: Fibrin glue for fixation for conjunctival autografts after primary nasal pterygium excision is safe and effective. The most common complication in the present study was graft dehiscence, which did not require surgical intervention. Keywords: Conjunctival autograft; Fibrin glue; Pterygium recurrence rate; Graft dehiscence

Effectiveness of bare sclera technique versus conjunctival autograft transplantation for pterygium treatment

Effectiveness of bare sclera technique versus conjunctival autograft transplantation for pterygium treatment

A STUDY ON EFFECT OF PTERYGIUM EXCISSION ON PTERYGIUM INDUCED ASTIGMATISM

Purpose: Methods: To determine the effect of pterygium excision on pterygium induced astigmatism. A statistical comparison of the refractive astigmatism before and after effective pterygium surgery was done on 30 patients who underwent preoperative and postoperative refraction testing. pterygium surgery caused si Results: gnicant improvements in visual acuity, with the rule astigmatism. The corneal astigmatism tended to decrease s Conclusion: ignicantly following pterygium excision with conjunctival limbal autograft transplantation.

The Outcome of Surgical Treatment of Giant Papillary Conjunctivitis by Simple Excision Only, Excision with Conjunctival Autograft or Amniotic Membrane Transplantation

The Outcome of Surgical Treatment of Giant Papillary Conjunctivitis by Simple Excision Only, Excision with Conjunctival Autograft or Amniotic Membrane Transplantation

Topical cyclosporine A and interferon alpha-2b as adjuvants to surgery to decrease pterygium recurrence.

Pterygium is very common in India and is usually removed by limbal conjunctival autograft transplantation (LCAT), which, despite being the first-line therapy, is still associated with recurrences of up to 18%. To compare the safety and efficacy of topical cyclosporine A (CsA) and interferon (IFN) alpha-2b in the prevention of postoperative recurrence of pterygium. A total of 40 patients with primary pterygium were randomized into two equal groups, Group C and Group I. Both the groups underwent LCAT, with Group C kept on topical cyclosporine 0.05% (CsA) 4 times daily and Group I on topical IFN alpha 2b 0.2 million IU 4 times daily postoperatively for 3 months. Pre- and posttreatment best-corrected visual acuity (BCVA), recurrence, and complications were assessed at day 1, week 1, 1 month, and 3 months. The mean preoperative BCVA of 0.51 ± 0.18 and 0.51 ± 0.23 improved to 0.13 ± 0.13 and 0.13 ± 0.13 in Group C and Group I, respectively, after 3 months of treatment (P < 0.0001). Recurrence was seen in 2 cases in Group C and in 1 case in Group I at 3 months. No significant complications occurred in either of the groups. Topical CsA and IFN Alpha-2b are newer efficacious adjuvants with LCAT for prevention of postoperative pterygium recurrence.

A prospective observational study on the effectiveness of pterygium excision with limbal conjunctival autograft transplantation and recurrence in patients of primary pterygium

Background: Pterygium is a degenerative and hyperplastic process with abnormal fibrovascular proliferation. Surgery is the treatment of choice in progressive or symptomatic cases but recurrence is a concern. Aims and Objective: We aim to evaluate the effectiveness of pterygium excision and conjunctival autograft (done by post-graduate trainees in the 2nd and 3rd year of residency under supervision) and recurrence of this process in a tertiary care setup. Materials and Methods: It is a single-centric prospective observational study. 50 patients who underwent pterygium excision with conjunctival autografting surgery in a tertiary care hospital were followed up for 1 year. Patients were evaluated on day 1, day 7, 1 month, 6 months, and 1 year. Efficacy and graft stability were assessed on day 7 and 1 month; 6 months and 1 year for recurrence and the factors associated with it. Results: Total number of patients was 50; 31 were female, and 19 were male. All cases were effectively managed with excision and autograft. Post-operatively, 13 (26%) patients had shown suture loosening, 17 (34%) patients had graft edema, and 13 (26%) patients had post-operative recurrence. Out of 13 patients, 8 patients had mild recurrence, 4 patients had moderate recurrence, and 1 patient had severe recurrence. Graft stability is significantly associated with suture loosening (P &lt; 0.05). There is no association between the extent and grade of pterygium (P &gt; 0.05). Recurrence was statistically highly associated with (P &lt; 0.0001) suture loosening. Conclusion: We conclude that autografting is an effective technique. Intraoperative proper suturing technique and minimal tissue manipulation can minimize recurrence.

Comparison of Efficacy and Safety of Two Commercial Artificial Tears Between 0.18% and 0.3% Sodium Hyaluronate for Corneal Epithelial Healing in Pterygium Excision with Conjunctival Autograft Transplantation: A Study Protocol for a Randomized Controlled Trial.

To compare the efficacy, safety, and rate of healing on the corneal epithelial defect after pterygium surgery through the application of either 0.18% or 0.3% sodium hyaluronate (SH). A randomized, double-blind clinical trial was performed on patients who had pterygium surgery. Eighty-six patients were randomized to 2 groups that would receive either 0.18% SH or 0.3% SH. Measurements of area of the corneal epithelial defect using ImageJ freeware were performed. All corneal epithelial defects were measured immediately after the operation (Day 0) and for the next 3 days. The mean and SD of the area of corneal epithelial defect measured on postoperative Day 0, 1, and 2 were 9.13 ± 3.09 mm2, 5.61 ± 3.26 mm2, and 3.39 ± 2.70 mm2 for 0.18% SH group, and 8.96 ± 3.17 mm2, 4.03 ± 1.99 mm2, and 1.55 ± 1.23 mm2 for 0.3% SH group. There was no statistically significant difference of the initial area of the corneal epithelial defect on Day 0 between 0.18% and 0.3% SH group (p = 0.802). The area of the defects in the 0.3% SH group was significantly smaller than that of the 0.18% SH group on both Day 1 and Day 2 (p = 0.007, p < 0.001), respectively. Similarly, the 0.3% SH group exhibited a statistically significant higher (p < 0.001) rate of healing of the corneal epithelial defect over days 0 and 1 (4.94 ± 2.16 mm²/day) when compared to that of the 0.18% SH group (3.53 ± 1.66 mm²/day). With two commercial artificial tears, the corneal epithelial wound healing after pterygium surgery was faster in the 0.3% SH group than that of the 0.18% SH group. Superiority of 0.3% SH may be supported by the presence of epsilon-aminocaproic acid in this drug preparation. No significant adverse effects were exhibited during the short-term follow-up.

A Randomized Controlled Trial to Manage Postoperative Ocular Pain after Pterygium Excision with Conjunctival Autograft Transplantation with a Single Application of 2% Sodium Hyaluronate.

Purpose To assess the effectiveness of a single application of 2% sodium hyaluronate (SH) in controlling pain after pterygium excision as compared with that of a control group. Methods We performed a prospective randomized controlled trial in the patients who underwent pterygium excision. The outcome of topical application of 2.0% SH was measured using the visual analogue scale (VAS), in comparison with that observed in a control group (without SH). The area of ocular surface defects was assessed by ImageJ freeware. Analysis of pain scores and ocular surface defects were observed from both groups immediately after the operation, Day 0, and 3 subsequent days. Results Thirty patients were randomly divided into control group and SH treatment group. The initial area of the ocular surface defect on Day 0 was approximately the same for both groups (p=0.242). The medians of pain score assessed by the VAS on Days 0, 1, and 2 were 5, 3, and 0 for the SH group and 6, 5, and 3 for the control group, respectively. The pain score was statistically significantly decreased in the SH group compared to the control group on Day 1 (p < 0.001) and Day 2 (p < 0.001). The pain level of both groups was nearly the same on Day 3 (p=0.141). The area of ocular surface defects was significantly different between two groups on Day 1 (p < 0.001) and Day 2 (p < 0.001). Postoperative complications were not observed. Conclusion A single topical application of 2% SH in pterygium excision was effective in relieving pain in the early postoperative period without any adverse effects. This innovation may provide alternative pain control in pterygium surgery.

Evaluation of the Efficacy of Different Pterygium Surgeries in Polish Caucasian Population.

The aim of the study was to compare the efficacy of the two most commonly used surgical methods for pterygium removal in the Polish population, conjunctival autograft versus amniotic membrane transplantation, and to evaluate the postoperative recurrence rate. A retrospective analysis of the medical records was conducted, including 65 patients who underwent surgery for primary or recurrent pterygium at an ophthalmology clinic in Bialystok, Poland, between 2016 and 2020. Surgical success (no regrowth) was achieved in almost half of the amniotic membrane patients (44%) and in most of the conjunctival autograft patients (79%), with statistical significance. The odds of successful surgery were 79% lower for subjects with amniotic membranes than for those with conjunctival autografts (OR with 95% CI = 0.21 (0.05; 0.94); p=0.045). Our study confirms that the conjunctival autograft surgeries present more favorable success rates in Polish Caucasian population when compared to procedures involving amniotic membranes.

Inferior Conjunctival Autograft Transplantation for Primary Pterygium

Objective: To evaluate postoperative recurrence rate and complications after inferior conjunctival autograft transplantation for primary pterygium. Materials and Methods: The present study was a retrospective Cohort study on 45 eyes in 45 patients that underwent inferior conjunctival autograft transplantation after pterygium removal in primary pterygium. The results of all patients were reviewed. The success rate was determined in terms of recurrence rate of pterygium. Postoperative complications were also analyzed. Results: The present study comprised 45 patients for 45 eyes, that undergone inferior conjunctival autograft transplantation after pterygium removal in primary pterygium. The mean follow-up was 14.2±10.1 months. Recurrence rate was 7% or three eyes, in one year follow-up. No serious complications were found. Conjunctival buttonhole was a major complication. Conclusion: Inferior conjunctival autograft transplantation after pterygium removal is an effective and safe treatment with low complications. This alternative surgical technique is used to preserve superior conjunctiva for future glaucoma filtering surgery. Keywords: Inferior conjunctival autograft; Primary pterygium; Glaucoma

Study of visual outcome and complications following conjunctival autograft transplant in management of primary pterygium

Introduction: Pterygium is a common degenerative disease of the anterior segment of the eye characterized by a wedge-shaped fibrovascular dysplasia of the bulbar conjunctiva with a prevalence of 12%. Exact etiology is unknown; risk factors include, long term exposure of ultraviolet B rays, dust, wind, chemicals and air pollution. To minimize recurrence after the traditional bare sclera surgical technique, adjuvant therapies and modifications to the surgical technique are being adopted. Geographically, Vijayapura is located close to the equator with inherent risk of higher ultraviolet radiation exposures. Of late there is an upsurge in the number of patients with diagnosed with pterygium opting for surgical correction. Conjunctival autograft transplant is promising modification of bare sclera technique is associated with significant reduction in pterygium-induced astigmatism thereby improved visual acuity, decreased postoperative complications and decreased recurrence rates. Objective: To evaluate the visual outcome and complications following conjunctival autograft transplant in management of primary pterygium. Methods: The present study was conducted in the department of Ophthalmology, B.L.D.E. deemed to be university Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapura between October 2019 to April 2021. A total of 52 patients above 18 years with a diagnosis of primary pterygium were included in the study. Age, gender, occupation, side and severity of pterygium was recorded. Preoperative visual acuity and corresponding decimal pin whole equivalent was calculated for each patient. Upon surgery with conjunctival autograft under local anaesthesia, postoperatively, visual acuity, corresponding decimal pin hole equivalent and complications were evaluated at day 1, day 7 and day 30. Comparison of pre and postoperative data was done using appropriate statistical tests. Results: Mean age of patients was 54.38±10.70 years and 69.3% belonged to the age group of 50-70 years. Slight female predominance was noted with female to male ratio of 1.17:1. Most of the patients were farmers (48.5%) followed by housewives (23.1%). All patients had nasal pterygium prominently on the left side than right (61.5% vs 38.5%). 76.9% patients had grade 2 pterygia. Preoperatively, most patients had a visual acuity of 6/24 (25%), followed by 6/36 (19.2%) and 6/60 (17.3%). The mean decimal equivalent value was 0.35±0.21. Compared to preoperative visual acuity, significant improvement was seen at postoperative day 1 (p=0.000), postoperative day 7 (p=0.001) and at postoperative day 30 (p=0.001). Similarly significant increase in the decimal equivalent postoperatively (0.001) than preoperative values. Factors including age, gender, occupation, side and severity had significant association on the visual outcome based on visual acuity at all follow ups. Most common postoperative complication at day1 was subconjunctival haemorrhage (36%) is the common one followed by graft edema (36%) and graft retraction (13.5%). Resolution of complications was seen by day 30.Conclusion: Conjunctival autograft is a feasible and safe option in patients with primary pterygium with severe grading.

Surgical Management of Unilateral Partial Limbal Stem Cell Deficiency: Conjunctival Autografts versus Simple Limbal Epithelial Transplantation.

PurposeTo evaluate the clinical outcomes of conjunctival autograft (CAG) versus simple limbal epithelial transplant (SLET) for management of unilateral partial limbal stem cell deficiency (LSCD).MethodsThis retrospective, comparative, interventional case series evaluated 30 eyes of 30 patients with unilateral partial LSCD. After corneal pannus dissection, 17 patients underwent CAG where graft was harvested from the ipsilateral or contralateral eye, while 13 patients underwent SLET where limbal biopsy was harvested from the contralateral eye. The primary outcome measure was anatomical success in the form of restoration of a completely epithelised, stable, and avascular corneal surface at last follow-up.ResultsBoth groups were comparable in terms of age at time of surgery, preoperative best-corrected visual acuity, median duration since injury, number of clock hours of limbus involved, and number of previous surgeries performed. The most common etiology for LSCD was chemical burns in both groups. The median duration of post-operative follow-up was 5.6 months [interquartile range [(IQR): 3.6–15.1] in the CAG group versus 6.2 months (IQR: 4.5–12.2) in the SLET group (p=0.75)]. The anatomical success rates were 86.5 ± 8.9% in the CAG group and 28.3 ± 13.7% in the SLET group at final follow-up visit (p = 0.025). Most failures in both groups occurred within the first 8 months after surgery.ConclusionFor eyes with unilateral partial LSCD secondary to chemical burns, CAG is a safe and effective method for restoring the corneal epithelium. Limbal transplantation may not be necessary for the treatment of partial LSCD.

Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

Tekrarlayan Pterjiyumlu Olgularda Konjonktival Otogreft Transplantasyonu ile Kombine Amniyotik Membran Transplantasyonu Cerrahisi Sonuçları

Aim: To evaluate the results of conjunctival autograft transplantation (CAT) combined with amniotic membrane transplantation (AMT) surgery in recurrent pterygium cases. Methods: This is a retrospective interventional case series involving patients admitted to our clinic with recurrent pterygium. Patients' examination and postoperative findings were taken through standard slit-lamp examinations. Fourteen eyes of 14 patients were included in the study. All cases were treated with excision, followed by CAT combined with AMT. Corneal recurrence was evaluated as the main result. Fibrovascular proliferation greater than 1 mm on the cornea was accepted as recurrence after surgery. Results: The mean age of patients was 56.4 ± 7.5 (range: 40 – 65) years. During the mean follow-up period of 24.9 ± 10.7 (range: 12 – 50) months, pterygium and symblepharon recurred in only one eye (7.1%) after 4 months. Conclusion: In this study, it was seen that acceptable results were obtain and low recurrence rates could be achieved with the combination of CAT and AMT for the treatment of recurrent pterygium.

The Effect of a Novel Strategy in Treating Primary Pterygium: A Prospective Randomized Clinical Study

We sought to compare the efficacy and safety of conjunctival autograft (CAG), amniotic membrane transplantation (AMT) with postoperative interferon alfa-2b (IFN alfa-2b), and modified conjunctival autograft plus amniotic membrane transplantation (mCAG plus AMT) with postoperative IFN alfa-2b for primary pterygium. Randomized controlled clinical trial. Eyes with nasal and primary pterygia were randomized in a 1:1:1 ratio to receive CAG, AMT with IFN alfa-2b, or mCAG plus AMT with IFN alfa-2b. Subjects were followed up for 12months. Primary outcomes included recurrence rate and complications. Secondary outcomes included corneal epithelium status, ocular surface symptom score, and visual acuity change. Eighty-five subjects (30 in the CAG group, 25 in the AMT group, and 30 in the CAG+AMT group) completed the 12-month follow-up. No complication or grade 4 recurrence was found. There was no significant difference among the 3 groups in recurrence grade, corneal epithelium status, and visual acuity change. Compared with mCAG+AMT, CAG has a negative effect (β=-0.62, P= .001), and AMT has a negative effect (β=-2.02, P < .001) on postoperative symptom scores. Compared with AMT, CAG has a positive effect (β= 1.28, P < .001) on postoperative symptom scores. All 3 strategies had good safety and clinical efficacy in the study. Compared with conjunctival autograft, the 2 surgeries using no autograft or limited autograft was less traumatic and gave more flexibility for future ocular surface condition changes.

Preliminary observation on the treatment of primary pterygium with modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon eye drops

Objective: To observe the clinical effect of modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon (IFN) alpha-2b eye drops in the treatment of primary pterygium. Methods: This was a prospective case-control study. Patients with primary pterygium were treated from June 1, 2018 to December 31, 2018 in the Department of Ophthalmology, Beijing Tongren Hospital, and they were divided into two groups (the experimental group and the control group) by the method of randomized block design. Patients in the experimental group received modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops, while patients in the control group received pterygium resection combined with conjunctival autograft transplantation. The pterygium type and size were observed before operation, while visual acuity, intraocular pressure and anterior segment details were recorded either. The follow-up was done at 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months after operation. The visual acuity, corneal epithelial defect, and pterygium recurrence were observed. All data in this manuscript are enumeration data, the expected frequency of pterygium type distribution in the two groups was more than 5, and the chi square test was used, fisher's exact test was used to compare the other data between the two groups. Results: Seventy patients (77 eyes) with pterygium were in this study, including 30 males and 40 females, aged from 50-70 years old. There were 35 cases (38 eyes) in the experimental group and 35 cases (39 eyes) in the control group. 12 months after operation there were 54 cases (60 eyes) including 28 cases (30 eyes) in the experimental group and 26 cases (30 eyes) in the control group with complete data. The corneal epithelium defects of 1 eye in each group was repaired within 7-14 days after operation, and the rest eyes were completely repaired within 7 days after operation. There was no significant difference in the distribution of corneal epithelial healing between the two groups (P= 1.00). There was no significant difference between the two groups in the number of eyes distribute with decreased visual acuity (2 eyes in each group), stable visual acuity (15 eyes in the experimental group and 23 eyes in the control group), and improved visual acuity (13 eyes in the experimental group and 5 eyes in the control group) (P=0.053). There was no recurrence in the two groups at 12 months after surgery, and there was no significant difference between the two groups in the number of patients with conjunctival hyperplasia of grades 1, 2 and 3 (P=0.405). Conclusions: Modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops got low recurrence rate for primary pterygium and less damage to the healthy conjunctival tissue. This combined treatment strategy provides a new choice for the treatment of pterygium. (Chin J Ophthalmol, 2020, 56: 768-773).