J Korean Ophthalmol Soc.  2009 Dec;50(12):1780-1788. 10.3341/jkos.2009.50.12.1780.

Recurrence Rates of Amniotic Membrane Transplantation, Conjunctival Autograft and Conjunctivolimbal Autograft in Primary Pterygium

• Kim CH
• Lee JK
• Park DJ

• KMID: 2212988
• DOI: http://doi.org/10.3341/jkos.2009.50.12.1780

Abstract

PURPOSE
To compare the recurrence rates and complications with amniotic membrane transplantation (fibrin glue group and suture group), conjunctival autograft and conjunctivolimbal autograft in excision of primary pterygium.
METHODS
Among 121 eyes of 115 patients with a minimum follow-up period of 12 months, 33 eyes of 31 patients underwent amniotic membrane transplantation with fibrin glue (Group 1) and 29 eyes of 28 patients underwent amniotic membrane transplantation with sutures (Group 2). Twenty-eight eyes of 26 patients underwent conjunctival autograft (Group 3), and 31 eyes of 30 patients underwent conjunctivolimbal autograft (Group 4). Recurrence rates and complications were evaluated retrospectively.
RESULTS
With a minimum of 12 months of follow-up, conjunctival recurrence was noted in seven eyes (21.2%) and six eyes (20.7%) in Group 1 and Group 2, respectively. Corneal recurrence occurred in one eye (3.0%) in Group 1 and in three eyes (10.3%) in Group 2 and no conjunctival or corneal recurrence were noted in Group 3 or Group 4. There was a statistically significant difference in conjunctival recurrence rates (p=0.003), but not in corneal recurrence rates (p=0.089) among the four groups.
CONCLUSIONS
Although amniotic membrane transplantation preserved the superotemporal conjunctiva and was a technically easy procedure, it had high conjunctival recurrence rates. Conjunctival autograft and conjunctivolimbal autograft are technically demanding and time consuming, but they are more effective in preventing conjunctival recurrence compared with amniotic membrane transplantation.

Keyword

Amniotic membrane transplantation; Conjunctival autograft; Conjunctivolimbal autograft; Pterygium; Recurrence rates

MeSH Terms

Adhesives
Amnion
Conjunctiva
Eye
Fibrin Tissue Adhesive
Follow-Up Studies
Humans
Pterygium
Recurrence
Retrospective Studies
Sutures
Transplants
Adhesives
Fibrin Tissue Adhesive

Figure

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  Figure 1. Classification of pterygium. (A) Grade T1 (atrophic), episcleral vessels are unobscured. (B) Grade T2 (intermediate), episcleral vessels are partially obscured. (C) Grade T3 (fleshy), episcleral vessels are totally obscured.

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  Figure 2. Grading of recurrence after pterygium surgery. (A) Grade 0, normal appearance of the operated site. (B) Grade 1, fine episcleral vessels in the excised area. (C) Grade 2, fibrovascular tissue in the excised area, reaching to the limbus, but not invading the cornea (conjunctival recurrence). (D) Grade 3, fibrovascular tissue invading the cornea (corneal recurrence).

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  Figure 3. Complications after pterygium surgery. (A) Sub-AM hemorrhage. (B) Sub-conjunctival graft hemorrhage. (C) Dornor site scarring. (D) Granuloma. (E) Dornor site limbal stem cell deficiency. (F) Wound gaping (yellow star).

Reference

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