Limbal-Conjunctival vs Conjunctival Autograft Transplant for Recurrent Pterygia

Fayez, Mashhoor F. Al

doi:10.1001/archophthalmol.2012.2599

Cited by 50 publications

(29 citation statements)

References 42 publications

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“…[8][9][10][11][12] In previous studies, the number of subjects was limited to 16 to 120, whereas investigation of the recurrent rate was analyzed in hundreds of subjects. 13,14 This study assessed postoperative topographic changes using over 460 subjects. Comparisons in the previous studies were performed between the preoperative and one point of postoperative visit without an observation of the time-course change.…”

Section: Discussionmentioning

confidence: 99%

Topographic Changes After Excision Surgery of Primary Pterygia and the Effect of Pterygium Size on Topograpic Restoration

Nejima

Masuda

Minami

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Section: Discussionmentioning

confidence: 99%

Topographic Changes After Excision Surgery of Primary Pterygia and the Effect of Pterygium Size on Topograpic Restoration

Nejima

Masuda

Minami

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…Also we want to provide the effect of limbal stem cells in only the excised head portion. Besides to exclude the favorable impact of healthy conjunctiva on pterygium recurrence such as in conjunctival autograft that emphasized in some article, we did not excised tenon's layer from adjacent conjunctiva that dislocated to the midline [6] [11] [12]. Although limbal otograft, the adjacent tenon's layer may be the possible cause of high recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, especially conjunctival-limbal autograft became the more preferred surgery, with a relatively shorter operative time and a low rate of recurrence as well as comparable to adjuvants [6]- [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is no clear explanation on the additive successful result of conjunctivallimbal autograft that is ensured by interaction effect of the grafts with each other or is ensured by pure effect of limbal autograft [6]. Pure limbal autograft, as a technique for pterygium surgery appears to be an appropriate model to test the knowledge acquired from recent studies and to determine the utility of this technique in the management of all forms of pterygium (etc., primary or recurrent) clinically.…”

Section: Introductionmentioning

confidence: 99%

“…They used conjunctival flap conjunction with limbus. However, we know that autologous conjunctival transplantation has favorable impact on recurrence [6] [9] [10]. The main difference between our technique and Shimazaki's is that we balance favorable impact of conjunctiva by unexcised tenon's tissue.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Limbal Autograft in Recurrence of Pterygium

Ciftci¹,

Dogan²,

Ciftci³

et al. 2015

OJOph

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Background: Assessing the effect of limbal autograft shifting in recurrence of pterygium. Methods: This single-center study was carried out in a tertiary health facility. A review of data on consecutive patients who underwent pure limbal autografts shifting after pterygium resection was done. In all the cases, the pterygia extended at least 3 mm beyond the limbus. The resected each limbal grafts included a width of 1.5 mm and a length of 2 or 3 mm of limbus and a depth of 250 μm. Schmer test was performed at the eighth month postoperatively. Pterygium recurrence was accepted endpoint of the study. One patient had recurrent pterygium, whereas the others had primary pterygium. Patients with other ocular surface diseases or ocular pathology and, patients who discontinued follow-up visits were excluded from the study. Results: The study included 10 patients, with 5 males and 5 females. Median age of the patients was 40 (25 -70). Follow-up was conducted for a minimum of 8 months for patients with recurrence and at least for 16 months for non-recurrent cases. Recurrence was observed in 6 patients out of 10, in one patient, atypia was reported and excluded from the study. Four recurrent patients experienced decreased levels of tears. The rest one patient with recurrence had not any tear abnormality. The remaining 4 patients responded well to the surgery. Because of the high recurrence rate, it was decided to terminate the study. Conclusions: Limbal autografts shifting alone is not an appropriate treatment for primary pterygium because of the high recurrence rate. KeywordsLimbal Autograft, Recurrence, Pterygium * Corresponding author. S. Ciftci et al. 102 Article SummaryPterygium is a complex disease and the benefits of limbal graft are limited when working alone. As such, pterygium may be defined as a final common formation of some interactive instabilities that constitute fibrovascular tissue. Dysfunction of the limbus affects the results of this study favorably whereas without excised tenon's layer affect the results of this study unfavorably. Currently conjunctival-limbal autografts combining with tenon's layer removal seem to manage many factors that actively participate in the formation of pterygium.This study has limited number of participants and lack of control group; however it proved several points and complimentary indications such as atypia, asymmetric dry eye, effects of limbus in recurrence and in multiple pterygium and effect of tenon's layer comparable to limbal stem cells. These are vital clues for the causes of recurrence.

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Comparison of Photochemical Crosslinking Versus Sutures for Bonding Conjunctival Grafts

Wang

Zhu

et al. 2019

Lasers Surg Med

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Background and ObjectivesTo explore whether Rose Bengal‐induced photochemical crosslinking (RB‐PCL) can be a replacement for sutures in conjunctival autograft bonding, we compared the safety, operating time, postoperative ocular signs, and inflammatory responses of RB‐PCL versus nylon suturing for sealing conjunctival autografts in rabbits.Study Design/Materials and MethodsThirty‐six New Zealand White rabbits underwent limbal conjunctival autografting using either sutures or RB‐PCL to attach conjunctival autografts to the bare sclera. Animals were randomized to one of two groups (18 per group): the suture group or RB‐PCL group. Photochemical crosslinking with a wavelength of 532 nm green light with an illumination intensity of 0.6 W/cm2 for 250 seconds (150 J/cm2) or suturing was performed followed by light examination at 3, 7, 28 days after surgery to evaluate the healing condition. Rabbits in each group were euthanized on day 3 (n = 6), 7 (n = 6), or 28 (n = 6) postoperatively, and the graft tissues from the surgical site were processed to evaluate inflammatory response by assessing protein levels of tumor necrosis factor α (TNF‐α), and interleukin 6 (IL‐6) as well as histological examination. Cell viability was evaluated by counting both total and dead cells on hematoxylin and eosin (H&E) stained tissue samples from both groups at 3 and 7 days after surgery. The surgery procedure time was recorded and the graft surface temperatures were measured before and after illumination.ResultsPhotochemical crosslinking effectively secured the limbal conjunctival autograft over an ocular conjunctival defect with no significant difference from the suture group. The time required for this light activated bonding method was ~550 seconds in comparison with the suture method of half hour. The differences of measured temperature on the graft surface before and after RB‐PCL treatment were 2.98 ± 0.11°C. The induction of IL‐6 and TNF‐α protein was remarkably reduced in the RB‐PCL group compared with the suture group at 3 and 7 days after surgery. Histology revealed less infiltrated neutrophils were observed in the RB‐PCL group than in the suture group at 3 and 7 days postoperatively. Furthermore, the RB‐PCL group showed a better healing process with less eye discharge and mild conjunctival congestion. No significant difference in percent dead cells was observed between RB‐PCL and suture groups at 3 and 7 days after surgery.ConclusionsRB‐PCL is a promising alternative for bonding the conjunctival autograft with shorter operation time, less inflammation and better healing outcomes compared to conventional suture. Thermal damage and phototoxicity were not observed using the RB‐PCL method in bonding conjunctival grafts. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Limbal-Conjunctival vs Conjunctival Autograft Transplant for Recurrent Pterygia

Abstract: Limbal-conjunctival autografts could be a favored option for managing advanced recurrent pterygia in young high-risk patients.

Cited by 50 publications

References 42 publications

Topographic Changes After Excision Surgery of Primary Pterygia and the Effect of Pterygium Size on Topograpic Restoration

Topographic Changes After Excision Surgery of Primary Pterygia and the Effect of Pterygium Size on Topograpic Restoration

The Effect of Limbal Autograft in Recurrence of Pterygium

Comparison of Photochemical Crosslinking Versus Sutures for Bonding Conjunctival Grafts

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