Experience of Sutured Limbal Stem Cell Conjunctival Autograft after Pterygium Excision
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Abstract
Background: To know the effectiveness of sutured limbal stem cell conjunctival autograft after pterygium excision in order to avoid recurrencies.
Method: This is a prospective study of limbal stem cell conjunctival autograft after pterygium excision during December 2011 until April 2012. Type of operation were pterygium excision followed by cojunctival limbal stem cell autograft. Follow up be conducted at day 1, 1 week, 1 and 3 month post operatively. The recurrence rate was evaluated using Portable PASW statistics 18 software.
Result: Twenty cases of pterygium had been operated. Ten cases could be evaluated 3 months. Three males and 7 females, average age was 50.2 ± 10.55 year, range 38-72. 2cases were pre existing recurrence pterygium. BCVA pre operation range 1.00 - 0.1. BCVA post operation range 1.00 – 0.20. One of 10 cases was recurrence after this study, the BCVA decrease and need repeated excision and limbal stem cell conjunctival autograft. There is no statistically significant correlation of the type of pterygium pre and recurrence post operatively. Moderate association was noted between BCVA pre operation and recurrence rate post operatively. Very strong association was noted between age of these patient and recurrence post operatively. There is a significantly differrence of BCVA before and after operations.
Conclusion: Sutured limbal stem cell conjunctival autograft after pterygium excision in order to avoid recurrencies was effective 3 months after operation. The recurrence rate is 10%. This study need more samples and comparring group with other technique in order to know this tehnique is better than other or not.
Keywords: Ocular surface disorder, corneal conjunctivalisation, pterygium excision, limbal stem cell transplantation
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References
Brightbill FS, Mc Donnel PJM, Mc Ghee CNJ, Farjo AA, Serdarevic ON, 2009. Corneal Surgery, Theory, Technique and Tissue. IVth ed, Mosby Elsevier inc, pp 25-29, 53, 187- 197, 241-251, 605-615
Bozkir N, Yilmaz S, Maden A, Minimally invasive pterygium surgery: A new approach for prevention of recurrence, European Journal of Ophthalmology, vol. 18 no. 1, pp. 27-31, 2008
Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985; 92: 1461-70.
Kwok LS, Coroneo MT. A model for pterygium formation. Cornea 1994; 13: 219-24.
Coroneo MT, Girolamo ND, Wakefield D. The pathogenesis of pterygium. Curr Opin Ophthalmol 1999; 10: 282-8.
Daya SM, Holland EJ, Mannis MJ, 2002. Living-Related Conjunctival Limbal Allograft. In (Edward JH, Mark JM, eds) Ocular Surface Disease: Medical and Surgical Management. New York: Springer-Verlag, pp 201-207.
Schwartz GS et al, 2002. Preoperative Staging of Disease Severity. In (Edward JH, Mark JM, eds) Ocular Surface Disease: Medical and Surgical Management. New York: Springer-Verlag, pp 158-166.
Tabin GC et al, 2002. Limbal Stem Cell Transplantation. In Corneal Transplantation. New Delhi: Jaypee, pp 235-244.
Kenyon KR, Tseng SCG. Limbal autograft transplantation for ocular surface disorders. Ophthalmology 1989; 96: 709-23.
Shimazaki J, Yang HY, Tsubota K. Limbal autograft transplantation for recurrent and advanced pterygia. Ophthalmic Surg Lasers 1996; 27: 917-23.
Gris O, Guell JL, del Campo Z. Limbal-conjunctival autograft transplantation for the treatment of recurrent pterygium. Ophthalmology 2000; 107: 270-3.
Fallah MR, Golabdar MR, Amozadeh J, Zare MA, Moghimi S,Fakhraee G. Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium. Eye 2008; 22: 420-4
Oguz H, Kilitcioglu A, Yasar M. Limbal conjunctival mini-autografting for preventing recurrence after pterygium surgery. Eur J Ophthalmol 2006; 16: 209-13.