Limbal-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.

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 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.

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.

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.

Incidence of pterygium recurrence following bare sclera technique with MMC in comparison to conjunctival autograft

Background: The gоal of this study is to compare incidence of recurrence of pterygium following bare sclera technique with mitomycin C in comparison to conjunctival autograft Methods: Our study included 40 cases subdivided into 2 groups; 20 cases managed by pterygium excision and intraoperative application of MMC 0.02% for 2 minutes and 20 cases managed by pterygium excision and limbal conjunctival auto graft transplantation ranged from 25 to 65 years old, with mean age of 44.2 years in 1st group, 43.8 years in 2nd group. SD in 1 st group +/- 10.2 and in 2nd group +/-11.3, in 1st group 14 cases (70%) were male and 6 cases (30%) were female, in 2nd group 15 cases (75%) were male and 5 cases (25%) were female. In 1st group the average of recurrence after two months is 3 cases with conjunctival recurrence. In 2nd group, the average of recurrence after two months is 1 case with episcleral vessels with p value <0.05. Results: It was found that recurrences of pterygium in patients managed with MMC are significantly higher than in patients managed with LCAG. Conclusion: LCAG is a good method in management for primary pterygium with low recurrence rate.

Effects of excimer laser phototherapeutic keratectomy in limbal-conjunctival autograft transplantation for recurrent pterygium: a retrospective case control study

BackgroundRepeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent pterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in limbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium.MethodsRetrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without (control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and postoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were collected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were performed to monitor the cornea epithelium healing and cellular recovery process respectively.ResultsA total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK. The mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and 13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: − 0.88, 2.81), SAI decreased 0.53 (range: − 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding values were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group, respectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both groups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: − 0.12, 0.50) in the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and better cellular recovery.ConclusionsFor recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved corneal surface and vision outcomes.

Early postoperative outcomes of pterygium surgery: Sutures versus autogenous serum in-situ fixation of limbal conjunctival autograft

Limbal Conjunctival Autograft Transplantation (LCAT) is considered to be the most effective treatment option for pterygium with the least recurrence rate and rapid restoration of normal epithelial morphology. Of the many available methods for securing Limbal Conjunctival Autograft (LCAG), sutures and autogenous serum in-situ are cost-effective and offers better outcomes. AimTo compare the outcome of surgeries between the two groups: Group I - LCAG secured with autogenous serum in-situ versus Group II - LCAG secured with sutures. Main methodsA prospective randomized control trial conducted on 60 patients who were equally divided into two groups. Post-operative follow-up visits were scheduled at 1st week, 3rd week and 6th week. They were examined for pain, foreign body sensation, subconjunctival hemorrhage, tearing, hyperemia, graft edema, graft displacement, graft retraction, recurrence and/or any other complications and were graded depending on the severity. Mean surgical time was compared between the two groups. Key findingsAverage duration of surgery was significantly less in Group I than in Group II. Postoperatively, symptoms like pain, foreign body sensation, tearing and hyperemia were less common in Group I, furthermore subconjunctival hemorrhage and graft edema were more in Group II. SignificanceThough both the procedures are safe and effective, the use of autogenous serum in-situ significantly shortens the duration of surgery and is accompanied by lesser postoperative discomfort and inflammation. However, long-term studies are needed to assess the risk of recurrence. Graft displacement remains a severe, but infrequent complication.

Analysis on the efficacy of different exsection range in pterygium

Objective To analyse the efficacy of different exsection range in pterygium excision combined with conjunctival limbal autograft transplantation. Methods The clinical data of 86 eyes of 86 patients with ptergium, from Jan. 2016 to Jan. 2017 were analyzed retrospectively.Among them 2 cases were recurrent pterygium. All cases were divided into 2 groups randomly.Group A, 44 cases, treated with pterygium extended excision combined with Tenon’s capsule excision.Group B, 42 cases, received obvious hyperplasia pterygium excision only.The follow-up time was 1 year.Postoperative recurrence rates, efficacy and complications between both groups were compared and analyzed. Results The difference of length, width of pterygium invaded the cornea and the age of onset were not statistically significant between the two groups (P=0.247, 0.185, 0.125). In group A, the conjunctival of grafting bed occurred persistent congestion in 3 eyes after surgery. At the end of follow up, no recurrent or scar exposure occured.In group B, there were 10 cases with repeated conjunctival congestion in grafting bed. The conjunctival fibrovascular tissue proliferation and significant scar tissue exposure occured in 5 eyes(11.9%). Conclusion Pterygium extended excision combined with Tenon’s capsule excision is an efficient method for pterygium.It may reduce recurrence and improve postoperative conjunctival congestion. Key words: Surgery; Pterygium; Exsection range; Recurrence

Clinical effect of limbal conjunctival autograft or amniotic membrane transplantation for the treatment of primary pterygium

Clinical effect of limbal conjunctival autograft or amniotic membrane transplantation for the treatment of primary pterygium

Amniotic membrane graft versus conjunctival autograft for the management of primary pterygium

Aim To compare amniotic membrane graft versus conjunctival autograft for the management of primary pterygium. Design A prospective, randomized study. Patients and methods Fifty eyes of 50 patients with primary pterygium were prospectively included in this study and were randomized into two groups. Group I included 25 patients who underwent surgical excision and limbal-conjunctival autograft transplantation; group II included 25 patients who underwent surgical excision and human amniotic membrane graft transplantation. Recurrence rate, refractive changes, and complications were evaluated and compared between both groups. Results Recurrence after surgical excision was observed in eight patients with an overall recurrence rate of 16% (8/50) in both groups. The recurrence was slightly higher in the amniotic membrane group, about 20% (five cases) than the conjunctival autograft group which was about 12% (three cases). The recurrence was higher in the first 3 months postoperatively which was about 62% (5/8) in both groups and increased to about 100% (8/8) at 6 months postoperatively. No recurrence was observed in either group after 6 months. Visual acuity improved in 22 and 23 patients while it remained unchanged in three and two patients in group I and group II, respectively. Conclusion Conjunctival autograft should be considered as the first choice for pterygium excision even in recurrent pterygia. Amniotic membrane graft can be considered as a first choice for patients with advanced and diffuse conjunctival involvement or for those who probably will need the conjunctiva for glaucoma-filtering procedure in the future.

Long-term results of limbal conjunctival autograft transplantation associated with an amniotic membrane in patients with total limbal stem cells deficiency

Long-term results of limbal conjunctival autograft transplantation associated with an amniotic membrane in patients with total limbal stem cells deficiency

Limbal conjunctival versus amniotic membrane in the intraoperative application of mitomycin C for recurrent pterygium: a randomized controlled trial.

This study compared the outcomes of a limbal conjunctival autograft (LCAG) with those of an amniotic membrane graft (AMG) followed by intraoperative 0.02% mitomycin C (MMC) to treat recurrent pterygium. In this randomized controlled trial, ninety-six eyes with recurrent pterygium were enrolled and randomly allocated into two groups using a computer-generated random number table. Pterygium removal was followed by intraoperative 0.02% MMC for 3min and then either LCAG or AMG transplantation. The major outcomes were recurrence rate, conjunctival inflammation grade, healing time of the corneal epithelial defect, eye-movement amplitude (EMA), uncorrected distance visual acuity (UDVA), and complications. A follow-up of 12months was conducted for 93 eyes of 82 patients. Grade D (recurrence) presented in one eye of the LCAG group and five eyes of the AMG group, with no between-group difference (p = 0.196). However, Grades A, B, and C presented in 46, zero and zero eyes of the LCAG group respectively, and in 37, two and two eyes of the AMG group respectively, with the surgical bed generally showing a better appearance in the LCAG group than in the AMG group (p = 0.008). Compared with baseline values, the postoperative EMA improved significantly in both groups (p < 0.001 for the LCAG group; p = 0.001 for the AMG group), as did UDVA (p = 0.005 for the LCAG group; p = 0.012 for the AMG group). No between-group differences were found in terms of the healing time for epithelial defect, conjunctival inflammation grade, or the frequency of complications such as punctate epithelial keratitis, episcleral melting, corneal pannus, and delayed corneal epithelium healing. LCAG transplantation with intraoperative 0.02% MMC is as efficacious in treating recurrent pterygium as AMG transplantation with MMC. The former procedure results in an attractive cosmetic appearance but might result in limbal damage in some eyes. The surgeon's familiarity with these procedures should determine the method of treatment.

Living-related limbal allograft transplantation for bilateral stem cell deficiency in a patient with bilateral chemical burn

INTRODUCTION. The purpose of this paper was to report the long-term outcome of a living-related limbal allograft transplantation followed by penetrating keratoplasty in a patient with severe bilateral stem cell deficiency. MATERIALS AND METHODS. A 50-year-old woman presented with extensive bilateral stem cell deficiency secondary to ocular acid burn on both eyes. Visual acuity was counting fingers at 30 cm on the right eye and counting fingers at 1 m Snellen line on the left. Limbal allograft transplantation on the right eye from a first-degree living-related relative was performed. The recipient was prepared by removing the abnormal corneal epithelium and vascularised pannus of the right eye under general anaesthesia. Two limbal allografts (mean length of 2–3 corresponding anatomic posi­tions on the recipient). Postoperatively, the host received systemic immunosuppression (steroids and cyclosporine). RESULTS. The cornea of the right eye achieved reepithelialisation within two weeks after surgery, followed by re­duction in vascularity in eight weeks time. After one year of regular follow up, the corneal surface remained stable whereas the stroma was opaque and the vision was low. Therefore, the patient underwent penetrating keratoplasty on the same eye. After the surgery the corneal graft was clear and the visual acuity on the right eye improved to 20/50 Snellen line. No graft rejection occurred after a five-year follow-up. CONCLUSION. Living-related limbal allograft transplantation is a good alternative option in cases of total bilateral stem cell deficiency whenever a conjunctival limbal autograft transplantation is not possible.

Investigation on the effects of eye drops of 0.3% hyaluronate sodium on ocular surface of after pterygium surgery

Objective To evaluate the the effects of 0.3% hyaluronate sodium eye drops on ocular surface of pterygium patients after limbal conjunctival autograft transplantation. Methods Prospective, double-blind, randomized, controlled clinical trial. Sixty eyes of 60 patients diagnosed as primary pterygium were randomly divided into two groups with 30 eyes in each group. All received pterygium resection combined with limbal conjunctival autograft transplantation by the same doctor. After operation, patients in the control group were given 0.5% levofloxacin, 0.1% fluorometholone eye drops 4 times a day. For that in treatment group, 0.3% sodium hyaluronate eye drops were added 1 day postoperatively, four times a day for 1 month. The follow-up time was 1 month. The healing of epithelium, the scores of clinical symptoms, corneal sensation, non-invasive breakup time of tear film (BUT), non-invasive tear meniscus height (TMH), and confocal microscopy examination were done and recorded. Results The scores of clinical symptoms at the 2, 3, 7 days after the surgery were lower in the treatment group than that in the control group(P 0.05). At day 2, the eyes with intact epithelium in treatment group was 17(57%), compared with control group only 9(30%)(χ2=4.344, P=0.037). TMH & BUT: at 14 and 28 days postoperatively, the TMH in the treatment group were higher than that in the control group(P 0.05). Corneal sensation: at each time point, there was no statistically significant difference between two groups(P>0.05). Confocal microscopy: at 7 days postoperatively, the epithelia of the pterygium resection area were assembled tightly without edema or inflammation cells infiltration in the treatment group; however, in the control group, some of the epithelial cells were swollen with inflammation cells infiltration. The corneal epithelial cells density was higher in the treatment group compared with the control group(P<0.05). Conclusion 0.3% hyaluronate sodium eye drops promote the healing of corneal epithelium, and significantly reduce the perioperative pain. Continual using 0.3% hyaluronate sodium eye drops could increase the TMH. Key words: Pterygium; Excision; Eye drops, hyaluronate sodium; Wound healing

Long-term comparison of limbal conjunctival autograft and bare sclera technique in pterygium surgery: a five-year follow-up trial

To compare the long-term results of limbal conjunctival autograft transplantation (LCAT) and bare sclera (BS) technique in pterygium surgery. The records of patients who underwent pterygium surgery with LCAT in the Sifa University Hospital and Batigoz Eye Health Center between April 2009 and February 2010 were retrospectively reviewed. The results are evaluated and compared with the chi-square test. A total of 258 patients, who had primary pterygium, were operated during the period of April 2009 and February 2010 with the BS technique and LCAT. A total of 179 eyes of 179 patients were included in the study. The mean follow-up period was 56.2 ± 4.3 months. A total of 34 of them were operated with the BS technique. A total of 145 patients underwent pterygium excision combined with LCAT. Recurrence was detected in 11 patients (32.35 %) who were operated with the BS technique and in 6 patients (4.13 %) with LCAT. The recurrence rates in the BS group were higher than the limbal conjunctical autograft group (p < 0.05). LCAT is an effective and safe treatment for primary pterygium.

A Study of Limbal Conjunctival Autograft Transplantation in Primary Pterygium

Aim : To study limbal conjunctival autograft transplantation in primary pterygium. Material and Methods: The present study was conducted on 100 eyes of 100 patients with primary pterygium attending the outpatient department of Ophthalmology department of Dr. Vasantrao Pawar Medical college, Nashik from July 2011 to June 2013 who were managed by Limbal Conjunctival Autografting(LCAT) which were performed by single surgeon. Result : This study shows that most of the patients belonged to age groups of 31-70. The mean pre-op astigmatism of 2.60 +2.20 Diopters (D) significantly reduced to 1.28 +1.22D postoperatively. There is significant improvement in Post operative Best Corrected Visual Acuity (BCVA) compared to preoperative BCVA with difference of 0.17+0.02. Postoperatively out of 100 eyes, 4 recurrences occurred with recurrence rate of 4%. Conclusion : Limbal Conjunctival Autograft transplantation is a safe and effective technique in management of Pterygium.

A Study of Limbal Conjunctival Autograft Transplantation in Primary Pterygium

&lt;strong&gt;Aim&lt;/strong&gt;: To study limbal conjunctival autograft transplantation in primary pterygium. &lt;strong&gt;Material and Methods:&lt;/strong&gt; The present study was conducted on 100 eyes of 100 patients with primary pterygium attending the outpatient department of Ophthalmology department of Dr. Vasantrao Pawar Medical college, Nashik from July 2011 to June 2013 who were managed by Limbal Conjunctival Autografting(LCAT) which were performed by single surgeon. &lt;strong&gt;Result&lt;/strong&gt;: This study shows that most of the patients belonged to age groups of 31-70. The mean pre-op astigmatism of 2.60 +2.20 Diopters (D) significantly reduced to 1.28 +1.22D postoperatively. There is significant improvement in Post operative Best Corrected Visual Acuity (BCVA) compared to preoperative BCVA with difference of 0.17+0.02. Postoperatively out of 100 eyes, 4 recurrences occurred with recurrence rate of 4%. &lt;strong&gt;Conclusion&lt;/strong&gt;: Limbal Conjunctival Autograft transplantation is a safe and effective technique in management of Pterygium.

Reconstruction of the limbal vasculature after limbal-conjunctival autograft transplantation in pterygium surgery: an angiography study.

We evaluated the angiographic features of the affected limbus in patients with pterygia and assessed limbal reconstruction outcomes after limbal-conjunctival autograft (LCA) transplantation in terms of vascular remodeling. We studied prospectively 31 eyes of 31 patients who underwent pterygium excision and LCA transplantation; 28 eyes of 28 normal participants served as controls. Anterior segment indocyanine green angiography (ICGA) was performed for each participant preoperatively and at 1 week, and 1 and 3 months postoperatively. The perioperative angiographic features of the pterygium were compared to those in normal eyes. The structural changes of the marginal corneal vascular arcades (MCAs) and LCA were quantitatively assessed postoperatively in terms of vascular density and lacunarity. Deteriorated MCAs that extended beyond the pterygium head were observed in the pterygium group. The pterygium had a dual blood supply from the conjunctival and episcleral circulations. In terms of limbal reconstruction, the engorged reperfusion vessels arose from the adjacent episcleral vessels along the limbus at 1 week postoperatively. The reconstructed MCAs had begun to appear at 1 month postoperatively and became apparent 3 months postoperatively in 26 (83.9%) of 31 eyes of the pterygium group, resulting in a successful clinical outcome. Higher vascular density and lower lacunarity were measured in the limbus and the graft at 3 months than at 1 month (P < 0.001 for all), which indicated fine reorganization of the reconstructed vessels. The pterygium had a dual blood supply, and the remodeling of the affected limbus and LCA continued up to 3 months postoperatively.