A Comparative Study Between Transplantation of Conjunctival Limbal Autograft with Mitomycin C and Amniotic Membrane Transplantation with Mitomycin C in Recurrent Pterygium

Document Type : Original Article

Authors

Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Egypt

Abstract

Introduction :
Pterygium, a wing‐shaped encroachment of the cornea by the conjunctiva, Conjunctival limbal autograft with stem cell (CLAU) or amniotic membrane transplantation (AMT) has been widely adopted in the management of pterygium.

Purpose:
To compare the efficacy and the complications of conjunctival limbal autograft (CLAU) with mitomycin C 0.2 % and amniotic membrane transplantation (AMT) with mitomycin C 0.2 % for treatment of recurrent pterygium
Subject and methods:
80 eyes of 60 patients clinically diagnosed with recurrent pterygium were divided into two groups , group A included 40 eyes underwent pterygium excision and MMC 0.2% with CLAU , group B included 40 eyes underwent pterygium excision and MMC 0.2% with AMT . Recurrence was defined as fibrovascular tissue extension of more than one mm onto the cornea in the area of previously excised pterygium. Mean follow up period 8±1 month . Recurrence was compared in each group by using ӽ2 test
Results:
No major postoperative complications occurred during 6-9 months of follow-up . In CLAU group (A)only 5 eyes of recurrence occur(12.5%)after 7 months of follow up . Recurrence occur in 12 eyes (30%)in AMT group (B) after 6 months ( P value =0.043, ӽ2 test).The operated site was look like the normal adjacent site in 77%of the non recurrence group A versus 10% in group B

Conclusion:
CLAU with MMC is more effective than AMT with MMC for treatment of recurrent pterygium and the final cosmetic appearance is more acceptable in CLAU group than AMT group B .

Keywords

References

  1. 1.Wu B. Advances in pathogenesis of pterygium. International Journal of Ophthalmology. 2014;14(6):1058–1060.

    2.Kurpakus-Wheater M, Kernacki KA, Hazlett LD. Maintaining corneal      integrity how the "window" stays clear. Prog Histochem Cytochem. 2001;36(3):185-259.

    3 Li X., Dai Y., Xu W., Xu J. Essential role of ultraviolet radiation in the decrease of corneal endothelial cell density caused by pterygium. Eye. 2018;32(12):1886–1892. doi: 10.1038/s41433-018-0188-y.

    4. Sousa H. C. C., Silva L. N. P., Tzelikis P. F. Corneal endothelial cell density and pterygium: a cross-sectional study. Arquivos Brasileiros de Oftalmologia. 2017;80(5):317–320. doi: 10.5935/0004-2749.20170077

    5.Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology. 1997;104:974–85.

    6. Masters JS, Harris DJ Jr. Low recurrence rate of pterygium after excision with conjunctival limbal autograft: A Retrospective Study With Long-Term Follow-Up. Cornea. 2015 Dec;34(12):1569-72.

    7. Tananuvat N, Martin T. The results of amniotic membrane transplantation for primary   pterygium compared with conjunctival autograft. Cornea. 2004 Jul;23(5):458-63.

    8. Shimazaki J, Kosaka K, Shimmura S, Tsubota K. Amniotic membrane transplantation  with  conjunctival autograft  for recurrent pterygium . Ophthamology 2003;40: 119-124.

    9. Luanratanakorn P, Ratanapakorn T, Suwan-Apichon O, Chuck RS. Randomised controlled study of  conjunctival autograft versus amniotic membrane graft in pterygium excision Br J Ophthalmol. 2006 Dec; 90(12): 1476–1480.

    10.Küçükerdönmez C, Akova YA, Altinörs DD. Comparison of conjunctival autograft with amniotic membrane transplantation for  pterygium surgery: surgical and cosmetic outcome. Cornea. 2007 May; 26(4):407-13.

    11. Saif ATS, Saif PS , El Deeb A. Role of amniotic membrane transplantation in symblepharon. Guoji Yanke Zazhi(Int Eye Sci) 2017;17(5):819-824

    12.Nassar M, Saif M, Saif A, Saif P. Sensitivity and specificity of nassar color test in early detection of diabetic macular edema. Journal of Retina-Vitreous. 2016;24:109-113.

     13.Amer, S. , Saif, M. , Saif, A. and Saif, P. (2014) Variations of Cup-to-Disc Ratio in Children. Open Journal of Ophthalmology, 4, 12-17. doi: 10.4236/ojoph.2014.41003.

    14.Nelson-Ayifah D, Mashige KP. Demographic and clinical characteristics of patients with glaucoma in a tertiary eye facility in Ghana. Afr Vision Eye Health. 2020;79(1), a521.

    15. Elhamrawy, M., SAIF, M., Mohamed, S., Said, M. Effect of Eye Movement Training on Balance in Post Stroke Patients with Unilateral Spatial Neglect. First Preliminary report. NILES journal for Geriatric and Gerontology, 2019; 2(1): 71-76. doi: 10.21608/niles.2019.58080

    1. Small Incision Cataract Surgery (MSICS). . Int J Ophthalmol Eye Res.2016; 4(2), 184-191
    2. Saif A, Saif P, Dabous O. Fundus changes in thalassemia in Egyptian patients. Delta Journal of Ophthalmology. 2017;18(1):20.
    3. Saif ATS, Saif PS , El Deeb A. Role of amniotic membrane transplantation in symblepharon. Guoji Yanke Zazhi(Int Eye Sci) 2017;17(5):819-824
    4.  Saif AT, Saif P. Achieving Target IOP. Glokom-Katarakt/Journal of Glaucoma-Cataract. 2017 Mar;12(1):60–9.
    5. Nassar M, Saif M, Saif A, Saif P. Sensitivity and specificity of nassar color test in early detection of diabetic macular edema. Journal of Retina-Vitreous. 2016;24:109-113.‏

Files

Share

How to cite

Statistics