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Amniotic membrane transplantation with conjunctival autograft for recurrent pterygium
Jun Shimazaki1, Koichi Kosaka, Shigeto Shimmura
1Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. jun@eyebank.or.jp
Objective:
To study the effect of amniotic membrane transplantation (AMT) combined with either limbal autograft transplantation (LAT) or conjunctival autograft transplantation (CAT) in recurrent pterygium.
Design:
Retrospective, noncomparative, interventional case series.
Participants:
Twenty-seven eyes of 27 patients with recurrent pterygium. The mean number of prior surgeries was 3.1 (range, 1-10). Fifteen eyes each had restriction of ocular movement and symblepharon before surgery.
Intervention:
Patients were treated by AMT with either LAT (n = 15) or CAT (n = 12).
Main Outcome Measures:
Recurrence of pterygium, improvement in ocular movement, and symblepharon formation.
Results:
Twenty-three (85.2%) of 27 eyes showed no recurrence with a mean observation period of 67.0 weeks. Fourteen eyes (93.3%) each showed improvement in ocular movement restriction and symblepharon after AMT. In four eyes that developed recurrence, three had LAT and one had CAT combined with AMT, suggesting that there was no difference in surgical outcome between LAT and CAT.
Conclusions:
AMT with CAT is a safe and effective method for recurrent pterygium, especially that associated with ocular movement restriction and symblepharon. Considering the potential adverse effects associated with limbal excision, AMT plus CAT may be preferred over AMT plus LAT.