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Purpose:To evaluate the efficacy of conjunctivo-limbal autograft after wide excision of primary and recurrent pterygia. Methods: Twenty-one eyes of 18 patients with primary pterygium and 18 eyes of 18 patients with recurrent pteygium underwent conjunctivo-limbal autograft after wide excision of pterygium. All patients underwent follow-up for more than six months. Recurrence rates and complications were evaluated. Results: With a minimum of six months of follow-up, fibrovascular tissue in the excised area, not invading the cornea, was noted in one eye (5.6%) in the recurrent pterygium group but no further surgical interventions for the cosmetic problem were needed. One eye (4.8%) showed wound dehiscence, three eyes (14.3%) showed subgraft hemorrhage, and one eye (4.8%) showed subconjunctival fibrosis at the donor site in the primary pterygium group, while two eyes (11.1%) showed subgraft hemorrhage, and one eye (5.6%) showed Tenon's Capsule granuloma at the donor site in the recurrent pterygium group. Conclusions: Conjunctivo-limbal autograft after wide excision of pterygium can be considered an effective treatment with low recurrence rates for both primary and recurrent pterygia.

23-34저자들은 군날개 수술에서 군날개와 그 주위조직의 광범위 절제 후 파이브린 글루 조직접합제를 이용한 양막이 식술을 시행하여 기존의 봉합에 의한 양막이식술과 비교 하여 재발율과 합병증 및 수술시간 등을 분석하였다. (Fig. 1). 대상과 방법수술시간은 결막절개를 시작한 시점부터 개검기를 제거한 시점까지를 분으로 나타내었고 재발여부는 Prabhasawat et al 17 에 의해 제안된 G0-G3 분류를 사용하였으며 그 내용은 세극등현미경 검사상 Grade 0은 재발이 없는 경우, Grade 1은 절제된 군날개영역 에 섬유화를 동반하지 않는 가는(fine) 상공막 혈관이 관찰되는 경우, Grade 2는 절제된 군날개 영역에 공막 내에 국한된 섬유혈관증식이 있는 경우(결막재발), Grade 3은 각막윤부를 가로지르는 섬유혈관증식이 있는 경우(각막재발)로 분류하였고, 본 연구에서는 Grade 2와 Grade 3를 재발로 정의하였다 (Fig. 2).양막이식시 사용된 양막은 Amnisite-cornea 통계학적인 분석은 statistical package for social sciences version 13.0 프로그램을 이용하였으며 두 군간의 재발율은 chi-square test로 비교하였고 환자 들간의 특성은 student's t-test와 chi-square test 를 이용하여 통계학적 유의성을 비교하였다. Table 1). 모든 경우에서 수술 후 2-3주에 결막상피재생이 이 루어졌다 (Fig. 4) Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea Purpose: To compare the efficacy and safety of fibrin glue and sutures for amniotic membrane transplantation after wide excision of primary pterygium. Methods: Forty-three eyes of 37 patients underwent amniotic membrane transplantation for primary pterygium with a minimum follow-up period of six months. Twenty-three eyes of 18 patients underwent surgery with fibrin glue and 20 eyes of 19 patients underwent surgery with sutures. Recurrence rates, complications, operating time were evaluated. Results: With a minimum of six-month of follow-up, fibrovascular tissue in the excised area, not invading the cornea (conjunctival recurrence), was noted in four eyes (17.4%) and fibrovascular tissue invading the cornea (corneal recurrence) was noted in two eyes (8.7%) in the fibrin glue group. Conjunctival recurrence was noted in five eyes (25%) and corneal recurrence was noted in one eye (5%) in the suture group. There was no significant difference in the recurrence rates between the two groups. Mean operating time in the fibrin glue group (25.2±3.5 minutes) was significantly shorter than in the suture group (40.5±3.6 minutes) (p=0.001, Students t-test). Complications included sub-amniotic membrane hemorrhage in three eyes (13%), and granuloma in one eye (4.3%) in the fibrin glue group, sub-amniotic membrane hemorrhage in four eyes (20%), granuloma in three eyes (15%), and wound dehiscence in one eye (5%) in the suture group. Conclusions: Using fibrin glue instead of sutures in amniotic membrane transplantation after wide excision of pterygium can be considered an effective treatment with shorter operating time and fewer complications, although there is no significant difference in recurrence rates.