open access

Vol 6 (2021): Continuous Publishing
Original paper
Published online: 2021-12-30
Get Citation

Conjunctival graft from pterygium tissue itself in primary pterygium surgery

Ramya Deepthi P1, Kumar Amruth C1, Prabhanjan Kumar P, Keerthi Teja1
·
Ophthalmol J 2021;6:245-248.
Affiliations
  1. Department of Ophthalmology, Narayana Medical College and Hospitals, Nellore, Andhra Pradesh, Nellore, India

open access

Vol 6 (2021): Continuous Publishing
ORIGINAL PAPERS
Published online: 2021-12-30

Abstract

Background: The aim of a study was to assess the efficacy of a new surgical technique that uses conjunctival tissuefrom the pterygium itself as a graft with a 180-degree rotation and fibrin glue in the primary pterygium surgery.

Material and methods: For this non-comparative, interventional study, 36 eyes from 36 patients with primary pterygium were operated on between January 2019 and December 2019. Pterygium was used to create a thin conjunctival graft (CAG) layer in this technique. This pterygium layer was entirely separated from the underlying fibrovascular tissue and retained on the corneal surface. A thin conjunctival graft was transferred to the bare sclera bed with the epithelial side up and rotated 180° before adhering to the bare sclera bed with fibrin glue. The primary outcome was the recurrence of pterygium. Other secondary variables included graft edema and graft retraction.

Results: The primary outcome was the recurrence of pterygium. Graft edema and graft retraction were considered as other complications. The average age was 47.5 years, with an 8-month follow-up. According to the study, the patients had an 8.3% recurrence rate (3 eyes out of 36). Graft edema was the only significant complication (52.77%, 19 eyes out of 36), which resolved without intervention. Graft retraction was the second most common complication, accounting for 27.7% of all cases (10 eyes out of 36).

Conclusion: In this technique, there is no tissue wastage (as in excision), no trauma to the normal area (as in conjunctival autograft), no suture-related complications, and shorter operating time. This technique can be used as a safe and alternative to CAG for patients in whom CAG cannot be performed with very low recurrence rates and complications.

Abstract

Background: The aim of a study was to assess the efficacy of a new surgical technique that uses conjunctival tissuefrom the pterygium itself as a graft with a 180-degree rotation and fibrin glue in the primary pterygium surgery.

Material and methods: For this non-comparative, interventional study, 36 eyes from 36 patients with primary pterygium were operated on between January 2019 and December 2019. Pterygium was used to create a thin conjunctival graft (CAG) layer in this technique. This pterygium layer was entirely separated from the underlying fibrovascular tissue and retained on the corneal surface. A thin conjunctival graft was transferred to the bare sclera bed with the epithelial side up and rotated 180° before adhering to the bare sclera bed with fibrin glue. The primary outcome was the recurrence of pterygium. Other secondary variables included graft edema and graft retraction.

Results: The primary outcome was the recurrence of pterygium. Graft edema and graft retraction were considered as other complications. The average age was 47.5 years, with an 8-month follow-up. According to the study, the patients had an 8.3% recurrence rate (3 eyes out of 36). Graft edema was the only significant complication (52.77%, 19 eyes out of 36), which resolved without intervention. Graft retraction was the second most common complication, accounting for 27.7% of all cases (10 eyes out of 36).

Conclusion: In this technique, there is no tissue wastage (as in excision), no trauma to the normal area (as in conjunctival autograft), no suture-related complications, and shorter operating time. This technique can be used as a safe and alternative to CAG for patients in whom CAG cannot be performed with very low recurrence rates and complications.

Get Citation

Keywords

conjunctiva; pterygium; autograft; fibrin glue; pterygium recurrence

About this article
Title

Conjunctival graft from pterygium tissue itself in primary pterygium surgery

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Original paper

Pages

245-248

Published online

2021-12-30

Page views

6046

Article views/downloads

398

DOI

10.5603/OJ.2021.0041

Bibliographic record

Ophthalmol J 2021;6:245-248.

Keywords

conjunctiva
pterygium
autograft
fibrin glue
pterygium recurrence

Authors

Ramya Deepthi P
Kumar Amruth C
Prabhanjan Kumar P
Keerthi Teja

References (25)
  1. Demartini DR, Vastine DW. Pterygium. Surgical interventions Corneal and External diseases. Grune and Straton, Orlando 1987: 141.
  2. Asokan R, Venkatasubbu RS, Velumuri L, et al. Prevalence and associated factors for pterygium and pinguecula in a South Indian population. Ophthalmic Physiol Opt. 2012; 32(1): 39–44.
  3. Nangia V, Jonas JB, Nair D, et al. Prevalence and associated factors for pterygium in rural agrarian central India. The central India eye and medical study. PLoS One. 2013; 8(12): e82439.
  4. Moran DJ, Hollows FC. Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol. 1984; 68(5): 343–346.
  5. Sencer WH. Ohthalmic Pathology: An Atlas and Textbook. Vol. 1 3rd ed. WB Saunders, Philadelphia 1985: 174–176.
  6. Di Girolamo N, Chui J, Coroneo MT, et al. Pathogenesis of pterygia: role of cytokines, growth factors, and matrix metalloproteinases. Prog Retin Eye Res. 2004; 23(2): 195–228.
  7. Ang LPK, Chua JLL, Tan DTH. Current concepts and techniques in pterygium treatment. Curr Opin Ophthalmol. 2007; 18(4): 308–313.
  8. Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 1985; 92(11): 1461–1470.
  9. Sune MP, Sune PG. Conjunctival Rotation Autograft for Pterygium: An Alternative to Conventional Conjunctival Autografting. Asia Pac J Ophthalmol (Phila). 2013; 2(4): 227–231.
  10. Jap A, Chan C, Lim L, et al. Conjunctival rotation autograft for pterygium. An alternative to conjunctival autografting. Ophthalmology. 1999; 106(1): 67–71.
  11. Luthra R, Nemesure BB, Wu SY, et al. Barbados Eye Studies Group. Frequency and risk factors for pterygium in the Barbados Eye Study. Arch Ophthalmol. 2001; 119(12): 1827–1832.
  12. Dupps WJ, Jeng BH, Meisler DM. Narrow-strip conjunctival autograft for treatment of pterygium. Ophthalmology. 2007; 114(2): 227–231.
  13. Rao SK, Lekha T, Mukesh BN, et al. Conjunctival-limbal autografts for primary and recurrent pterygia: technique and results. Indian J Ophthalmol. 1998; 46(4): 203–209.
  14. Sharma AK, Kumar VB. Rotational grafting of pterygium. Indian J Ophthalmol. 1984; 32(3): 149–151.
  15. Hirst LW. Recurrent pterygium surgery using pterygium extended removal followed by extended conjunctival transplant: recurrence rate and cosmesis. Ophthalmology. 2009; 116(7): 1278–1286.
  16. Liang W, Li R, Deng X. Comparison of the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation . Eye Sci. 2012; 27(2): 102–105.
  17. Moriarty AP, Crawford GJ, McAllister IL, et al. Severe corneoscleral infection. A complication of beta irradiation scleral necrosis following pterygium excision. Arch Ophthalmol. 1993; 111(7): 947–951.
  18. Chen PP, Ariyasu RG, Kaza V, et al. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol. 1995; 120(2): 151–160.
  19. Karalezli A, Kucukerdonmez C, Akova YA, et al. Does topical bevacizumab prevent postoperative recurrence after pterygium surgery with conjunctival autografting? Int J Ophthalmol. 2014; 7(3): 512–516.
  20. Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 1985; 92(11): 1461–1470.
  21. Mutlu FM, Sobaci G, Tatar T, et al. A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology. 1999; 106(4): 817–821.
  22. Tan D. Conjunctival grafting for ocular surface disease. Curr Opin Ophthalmol. 1999; 10(4): 277–281.
  23. P. RD, C KA. Pterygium excision with conjunctival autograft with autologous blood. Indian J Clin Experiment Ophthalmol. 2020; 4(4): 548–550.
  24. Maheshwari S, Maheshwari S. Split-conjunctival grafts for double-head pterygium. Indian J Ophthalmol. 2005; 53(1): 53–55.
  25. Wu WK, Wong VWY, Chi SCC, et al. Surgical management of double-head pterygium by using a novel technique: conjunctival rotational autograft combined with conjunctival autograft. Cornea. 2007; 26(9): 1056–1059.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Publisher: VM Media Group sp. z o.o., Grupa Via Medica, 73 Świętokrzyska St., 80–180 Gdańsk

tel.:+48 58 310 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl