Mitomycin C and conjunctival autograft for recurrent pterygium

Altiparmak, Uğur; Katircioğlu, Yasemin A.; Yağcı, Ramazan; Yalnız, Züleyha; Duman, Sunay

doi:10.1007/s10792-007-9085-2

Cited by 11 publications

(5 citation statements)

References 33 publications

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“…We believe this stems from the use of MMC, which suppresses recurrence and improves cosmetic appearance (white eye) when applied properly. [16–18] Additionally, none of our patients experienced symblepharon, a result consistent with previous reports of inferior conjunctival autograft transplantations. [81922] Although there have previously been reports of pseudopterygium at the superior or inferior limbal-conjunctival donor sites, none of our patients experienced this complication, which, again, is consistent with previous work using the limbal conjunctival transplantation.…”

Section: Discussionsupporting

confidence: 91%

“…These include “fibrovascular tissue crossing the limbus onto clear cornea in the area of previous pterygium excision” or other similar expressions, which we used when defining “recurrence” in this study. [57121820] These issues are reasons of controversy in the literature. Therefore, such issues make the evaluation of treatment more complicated and controversial.…”

Section: Discussionmentioning

confidence: 99%

“…[14] Subsequently, intraoperative 0.02% MMC application has been used instead, without severe complications. [15–18] With the improvements in surgical techniques, primary pterygium recurrence rates have decreased. However, there are still several controversies regarding the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Separate limbal-conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium

Kawano

Sakamoto³

2011

Oman J Ophthalmol

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Background:Inferior limbal-conjunctival autograft transplantation has been described as a safe and effective treatment for primary pterygium. However, despite its multiple advantages, routine performance of this technique is difficult because the inferior conjunctiva is often too small to provide enough autograft material. To resolve this issue, we modified a technique, inferior separate limbal-conjunctival autograft transplantation, and evaluated its efficacy and safetyMaterials and Methods:A total of 50 eyes of 47 patients were retrospectively studied. Our surgery consisted of a thorough pterygium excision followed by 0.02% mitomycin C application. Next, we performed inferior conjunctival autografting, in which limbal and bulbar conjunctival autografts were independently harvested and secured to the denuded limbus and the most posterior conjunctival defect at the pterygium excision site to ensure stem-cell restoration and deep fornix reconstruction, respectively; the bare sclera between the two grafts was exposed. The outcome was assessed with a three-point grading scale at the patient's last visit.Results:The success and recurrence rates were 96.0% (48 of 50) and 0%, respectively, assessed at follow-ups occurring at a mean of 19.2 ± 5.6 months after surgery. Only minimal complications were encountered.Conclusion:A combination of inferior separate limbal-conjunctival autograft transplantation with intraoperative 0.02% mitomycin C application is a safe and effective technique enabling the routine use of under-sized autografts harvested from the inferior conjunctiva after thorough pterygium excision.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Separate limbal-conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium

Kawano

Sakamoto³

2011

Oman J Ophthalmol

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“…Greft reperfüzyonunu geciktirebileceği için aşırı koterden kaçınıl-malıdır. 16 Çalışmamızda, 1 (%3,3) hastada birinci haftada gelişen granülasyon dokusu medikal tedavi ile düzelmiştir. Hastalarımızda preoperatif nüks piterjiyum olmaması, sütür kullanılması, minimal koter uygulaması, greftin ince ve tenondan arındı-rılmış olması gibi nedenlerden dolayı komplikasyonlarımızın az olduğu düşünülmektedir.…”

Section: Discussionunclassified

Effect of Limbal Conjunctival Autogreft Treatment on Corneal Astigmatism in Pterygium Patients

Bardak¹,

Eryiğit²

2015

Turkiye Klinikleri J Ophthalmol

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iterjiyum; dejeneratif bulber konjonktivanın korneaya doğru subepitelyal fibrovasküler proliferasyonudur. İnterpalpebral bölgede ve özellikle nazal limbusta bulunan piterjiyum; kapak, baş ve gövdeden oluşmakta-dır. th month mean CVA was 0.78±0.22. The decrease in astigmatism and increase in CVA were both statistically significant. The granulomatous reaction was seen in 1 (3.33%) eye at postoperative 7 th day control. The reoccurrence of pterygium was observed in 1 (3.33%) eye at postoperative 6 th month control. C Co on n--c cl lu us si io on n: : Limbal conjunctival autogreft surgery is safe and effective treatment method in primary pterygium patients.

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“…[5][6][7][8][9] Bu da MMC kullan›larak uygulanan cerrahiler sonras› hastalar›n uzun dönem yak›ndan takibini gerektirdi¤inden MMC kullan›m›-n› özellikle rekürren vakalara saklamak daha ak›lc› bir yol gibi gözükmektedir. 12 Bizim serimizdeki gözlerden 9'unda (%50) intraoperatif MMC uygulanm›fl olup hepsi de primer pterjiyumlard›r. Bu olgularda komplikasyon nisbeten erken say›labilecek bir dönemde (ortalama postoperatif 6,55±4,04 ay, minimum 2, maksimum 14 ay) ortaya ç›km›flt›r.…”

Section: Tart›flmaunclassified

Pterjiyum Cerrahisinin Nüks Dışı Komplikasyonları

Palamar¹,

Eğrilmez²,

Yağcı³

2011

Tjo

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ÖzetAmaç: Klini¤imize yönlendirilmifl olgular› sunarak pterjiyumun nüks d›fl› komplikasyonlar›na dikkat çekmek. Gereç ve Yöntem: Klini¤imize yönlendirilen 18 hastan›n 20 gözüne ait veriler retrospektif olarak de¤erlendirildi. Olgular›n yafl, cinsiyet, efllik eden hastal›klar›, baflvuru an›ndaki ve sonuç en iyi düzeltilmifl görme keskinlikleri, primer cerrahiye ait bilgileri de¤erlendirildi. Uygulad›¤›m›z tedavi yöntemleri not edildi. Sonuçlar: Olgunun yafl ortalamas› 51,62±9,86 (37 ve 67 aras›nda) idi. Olgular›n tamam› primer pterjiyum nedeniyle opere edilmiflti. Dokuz gözde ç›plak sklera tekni¤i, 9 gözde intraoperatif Mitomisin C (MMC) uygulanm›flt›. Befl gözde kötü yara duda¤› sütürasyonu, 3 gözde ise afl›r› koter kullan›m›na ba¤l› komplikasyon geliflti¤i izlendi. Saptanan komplikasyonlar pyojenik granülom, inklüzyon kisti, Dellen, skleromalazi, limbal yetmezlik ve perforan yaralanma idi. Alt› gözde t›bbi tedavi yeterli olurken, geri kalan 14 göze cerrahi tedavi uyguland›. Tart›flma: Pterjiyum cerrahisi hafife al›nmamal›d›r. Cerrahinin her aflamas›nda azami dikkat gösterilmeli ve adjuvan ajanlara ba¤l› geliflebilecek komplikasyonlar unutulmamal›d›r. Peroperatuar antimitotik ajan kullan›m› seçilmifl vakalara saklanmal›, afl›r› koterizasyon ve skatrizasyonu tetikleyecek genifl cerrahi diseksiyonlardan kaç›n›lmal›d›r. (Turk J Ophthalmol 2011; 41: 151-5) Anahtar Kelimeler: Komplikasyon, mitomisin C, perforasyon, pterjiyum, skleromalazi Summary Purpose: To draw attention to non-recurrence complications of pterygium surgery by reporting the cases of patients who were referred to our clinic. Material and Method:The data of 20 eyes of 18 patients were evaluated retrospectively. Age, gender, accompanying diseases, best corrected visual acuities at the time of referral and at last visit, and data related to primary surgery were assessed. The treatment modalities we used were noted. Results: The mean age of the patients was 51.62±9.86 (range: 37-67) years. All cases had been operated for primary pterygium. Bare sclera technique had been used in 9 eyes and intraoperative mitomycin C (MMC) had been applied in 9 eyes. Complications related to poor suturing technique were observed in 5 eyes and to excessive cauterisation -in 3 eyes. The detected complications were pyogenic granuloma, inclusion cyst, dellen, scleromalacia, limbal insufficiency, and globe perforation. Medical therapy was sufficient in 6 cases, whereas the remaining 14 eyes had to undergo surgical treatment. Discussion: Pterygium surgery should not be underestimated. Maximum attention must be paid in every step of the surgery and complications that might develop related to adjuvant agents should not be neglected. Perioperative antimitotic agent use should be saved for selected cases, excessive cauterisation and wide surgical dissections that might trigger cicatrisation must be avoided. (Turk J Ophthalmol 2011; 41: 151-5)

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Mitomycin C and conjunctival autograft for recurrent pterygium

Abstract: Intraoperative application of 0.2 mg/ml Mitomycin-C combined with conjunctival autograft reduces recurrence in recurrent pterygium cases, with minimal complications.

Cited by 11 publications

References 33 publications

Separate limbal-conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium

Separate limbal-conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium

Effect of Limbal Conjunctival Autogreft Treatment on Corneal Astigmatism in Pterygium Patients

Pterjiyum Cerrahisinin Nüks Dışı Komplikasyonları

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