Healing of autologous conjunctival grafts in pterygium surgery

Ghoz, Noha; El‐Alfy, Mohamed; Said, Dalia G.; Dua, Harminder S

doi:10.1111/aos.13794

Cited by 18 publications

(21 citation statements)

References 35 publications

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“…Our findings are in agreement with a recent study using qualitatively slit-lamp photographs, in which the authors reported that underperfusion areas were observed in the CAGs at postop-erative weeks 4-8, and a well-formed vascular network was noted after 8 weeks to 6 months. 20 However, that study provided no quantitative evaluation because it was undertaken using photographs alone. OCTA may offer the ability to detect early graft hypoperfusion or subclinical graft hypoperfusion before graft ischemia is noted by slitlamp biomicroscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Reperfusion with vessels anastomose with vasculature in the surrounding conjunctiva and underlying episclera allows reoxygenation and transport of nutrients that could help in the resolution of tissue edema. 20,22 The average bulbar conjunctival epithelial thickness has been reported to be between 42.4-54.7 mm, 23,24 and therefore we set 60 mm as the targeted thickness to achieve tenon-free grafts. The depth was also based on the results of our preclinical study showing that cutting of 60-mm grafts was associated with less deviation and variability than cutting deeper.…”

Section: Discussionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery

Liu

Devarajan

Tan

et al. 2019

American Journal of Ophthalmology

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PURPOSE: To describe the use of optical coherence tomography angiography (OCTA) to quantitatively monitor the conjunctival graft revascularization after pterygium excision and conjunctival autograft (CAG) transplantation.DESIGN: Prospective, interventional case series. METHODS: Ten patients undergoing pterygium excision and femtosecond laser-assisted CAG transplantation were included. OCTA was performed at 1 week, 1 and 3 months postoperatively at the CAG transplantation site and harvested area. The vessel density at three different depths: conjunctival epithelium or CAG epithelium, conjunctival stroma or CAG stroma, and episclera, was evaluated and quantified. The revascularization rate was assessed and correlated with the postoperative CAG thickness. RESULTS: No intraoperative and postoperative complications occurred. Reperfusion of the CAGs was observed at 1 week, and early reperfusion within the first month accounted for more than half of graft revascularization. The vessel regrowth density was 9.6±2.6 % and 11.1±2.8 % between 1 week and 1 month, and was 9.8±1.8 % and 11.9±1.9 % between 1 and 3 months, at the CAG and underlying episcleral levels, respectively. All the CAGs were well-perfused at 3 months. The vessel regrowth density was significantly and strongly correlated with the changes of CAG thickness in a negative relationship (g [ -0.94, P [ 0.019). At the harvested site, the vascular network of episclera was not affected, and the conjunctival vascularization was restored at 1 month. CONCLUSIONS: OCTA is a promising tool to evaluate the vascularization or revascularization of conjunctiva, conjunctival graft and episclera, in a quantitative and serial manner, helping in diseases diagnosis and treatment monitoring. The graft revascularization rate was predictive of postoperative graft deswelling.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery

Liu

Devarajan

Tan

et al. 2019

American Journal of Ophthalmology

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“…Pada fase setelah operasi pterigium hari pertama akan terjadi proses reperfusi setelah cedera 11 . Proses reperfusi tersebut dimulai sejak hari pertama (setelah operasi) 11 .…”

Section: Pembahasanunclassified

“…Pada fase setelah operasi pterigium hari pertama akan terjadi proses reperfusi setelah cedera 11 . Proses reperfusi tersebut dimulai sejak hari pertama (setelah operasi) 11 . Pada hari pertama ini sudah terjadi berbagai mekanisme termasuk aliran darah yang mulai di bangun pada pembuluh darah setelah dilakukannya operasi 11 .…”

Section: Pembahasanunclassified

“…Proses reperfusi tersebut dimulai sejak hari pertama (setelah operasi) 11 . Pada hari pertama ini sudah terjadi berbagai mekanisme termasuk aliran darah yang mulai di bangun pada pembuluh darah setelah dilakukannya operasi 11 . Semua mekanisme reprefusi dan perbaikan tersebut menyebabkan proses pemulihan pasien pasca operasi pada pterigium tidak membutuhkan waktu yang lama.…”

Section: Pembahasanunclassified

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Perbedaan Lama Pemulihan Pasca Operasi Pada Pasien Katarak Dan Pterigium Di Rumah Sakit Samaritan Palu Tahun 2019

Hutasoit

2019

HTJ

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Gangguan penglihatan dan kebutaan di dunia terus mengalami peningkatan. Prevalensi gangguan penglihatan dan kebutaan di Indonesia sebesar 1,5%. Penyebab gangguan penglihatan dan kebutaan antara lain katarak dan pterigium. Penelitian ini berujuan untuk membantingkan lama perawatan pasca operasi pada pasien katarak dan pasien pterigium. Penelitian ini merupakan penelitian deskriptif analitik dengan sampel 40 pasien yang terdiri dari 2 kelompok. Kelompok pertama adalah 20 orang pasien yang telah menjalani operasi katarak dan kelompok berikutnya adalah 20 orang pasien yang telah menjalani operasi pterigium. Hari perawatan fase penyembuhan pasca operasi kedua kelompok kemudian dibandingkan dengan uji statistkin menggunakan SPSS. Hasil dengan analisis data dengan uji normalitas Shapiro-Wilk menunjukkan distribusi data yang tidak normal sehingga uji yang dilakukan menggunakan uji non parametrik. Uji non parametrik dilakukan dengan Wilcoxon rank-sum test memberikan hasil hari rawat pada pasien pasca operasi katarak lebih lama dibandingkan dengan hari rawat pasien pasca operasi pteritium (p<0,05). Pasien pasca operasi katarak akan mengalami banyak proses penyembuhan yang dapat berlangsung dalam berminggu-minggu dibandingan dengan pasien pasca operasi pterigium sehingga proses tersebut menyebabkan masa perawatan penyembuhan pasca operasi pada katarak menjadi lebih lama.

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In vivo confocal microscopy findings about ocular surface recovery in patients following pterygium excision combined with conjunctival autograft

Xu,

Shen,

Zhang

et al. 2024

Int Ophthalmol

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Purpose To study cellular and neural changes around the donor and recipient areas after pterygium excision combined with autologous conjunctival transplantation using corneal confocal microscopy, we evaluated the postoperative impact of this surgical procedure. Methods Patients with primary pterygium located on the nasal side who visited the Department of Ophthalmology of Wuxi Second People’s Hospital between April and August 2023 were enrolled. Age-matched healthy eyes were included as the control group. IVCM was performed in the affected eyes, 6 months after pterygium excision. The images of the central conjunctival cells in the recipient and donor areas, the cells of each layer of the cornea around the recipient and donor area (around 2 mm from the nasal and upper corneal margins), and the structures of the corneal margins were recorded in the affected eyes and statistically compared with the corresponding areas in the control eyes. Results Seventeen eyes of 14 patients with primary pterygium located on the nasal side (mean 64 ± 8.74 years old), and 17 eyes of nine patients as age-matched normal controls were included. Compared with those of normal eyes, the density of corneal pterygoid epithelium around the recipient area (5104 ± 599 cells/mm 2 vs. 5700 ± 515 cells/mm 2 , P < 0.01) and the central conjunctival epithelial cells in the recipient areas (3984 ± 453 cells/mm 2 vs. 4834 ± 244 cells/mm 2 , P < 0.01) were significantly lower 6 months postoperatively. However, the superficial stromal, deep stromal, and endothelial cell densities around the recipient area exhibited no significant differences ( P > 0.05). Highly illuminated basal cells were visible at the nasal corneal margin, with an irregular intersection of fibrous tissue with corneal epithelial cells. More dendritic Langerhans cell infiltration was seen in the junctional area. Compared with those in the normal eyes, the densities of the corneal pterygoid epithelium (4896 ± 428 cells/mm 2 vs. 5557 ± 367 cells/mm 2 , P < 0.01), deep stromal cells (337 ± 65 cells/mm 2 vs. 419 ± 39 cells/mm 2 , P < 0.01), endothelial cells (2305 ± 170 cells/mm 2 vs. 2547 ± 212 cells/mm 2 , P < 0.01) around the donor area and the central conjunctival epithelial cells (3700 ± 446 cells/mm 2 vs. 4282 ± 272 cells/mm 2 , P < 0.01) in the donor area were significantly lower 6 months postoperatively. However, no significant differences were observed in superficial stromal cell density ( ...

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Healing of autologous conjunctival grafts in pterygium surgery

Cited by 18 publications

References 35 publications

Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery

Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery

Perbedaan Lama Pemulihan Pasca Operasi Pada Pasien Katarak Dan Pterigium Di Rumah Sakit Samaritan Palu Tahun 2019

In vivo confocal microscopy findings about ocular surface recovery in patients following pterygium excision combined with conjunctival autograft

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