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The Outcomes of Limbal Conjunctival Autograft Transplantation in The Treatment of Primary and Recurrent Pterygiums

Year 2020, Volume: 9 Issue: 2, 41 - 46, 31.08.2020
https://doi.org/10.47493/abantmedj.2020.6

Abstract

INTRODUCTION: To evaluate the results of limbal conjunctival autograft transplantation (LCAT) in patients with primary and recurrent pterygium.
METHODS: Forty-two eyes of 38 patients were included in the study. 26 of them were primary, while 16 were recurrent pterygium. Limbal conjunctival autograft transplantation was performed after the pterygium excision to all eyes. Patients having a follow-up of at least 12 months were evaluated with respect to demographic data, pterygium grade, surgical complications, recurrence rate, refractive astigmatism and visual acuity.
RESULTS: The mean age of the patients was 44 ± 8.5. Twenty-six (68.4%) patients were male and 12 (31.6%) were female. No recurrence were observed in primary pterygium group, whereas two recurrences were observed in recurrent pterygium group. The overall recurrence rate was 4.7%. Buttonhole complication occurred while forming the graft in three patients. Conjunctival inclusion cyst developed in 2 patients with recurrent pterygium.
DISCUSSION AND CONCLUSION: Limbal conjunctival autograft transplantation seems to be an effective and safe surgical option in both primary and recurrent pterygiums.

References

  • Young AL, Cao D, Chu WK, Ng TK, Yip YWY, Jhanji V, Pang CP. The Evolving Story of Pterygium. Cornea. 2018;37 Suppl 1: 55-7.
  • Saw SM, Tan D. Pterygium: prevalence, demography and risk factors. Ophthalmic Epidemiol. 1999;6(3):219-28.
  • Süren E, Uçakhan Gündüz ÖÖ, Kanpolat A. Pterjium Tedavisinde Yenilikler. MN Oftalmol. 2010;17(1):71–7.
  • Fernandes M, Sangwan VS, Bansal AK, Gangopadhyay N, Sridhar MS, Garg P, Aasuri MK, Nutheti R, Rao GN. Outcome of pterygium surgery: analysis over 14 years. Eye (Lond). 2005;19(11):1182-90.
  • Daya SM. Conjunctival-limbal autograft. Curr Opin Ophthalmol. 2017;28(4):370-6.
  • Donepudi GD, Ramesh S, Govindarajulu M, Dhanasekaran M, Moore T, Ganekal S, Hiremath CS. Early postoperative outcomes of pterygium surgery: Sutures versus autogenous serum in-situ fixation of limbal conjunctival autograft. Life Sci. 2019; 221:93-8.
  • Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol. 1997;115(10):1235-40.
  • Jaworski CJ, Aryankalayil-John M, Campos MM, Fariss RN, Rowsey J, Agarwalla N, Reid TW, Dushku N, Cox CA, Carper D, Wistow G. Expression analysis of human pterygium shows a predominance of conjunctival and limbal markers and genes associated with cell migration. Mol Vis. 2009; 15:2421-34.
  • Bhargava P, Kochar A, Joshi R. Pterygium excision followed by sutureless and gluefree infero-temporal conjunctival autograft. DJO 2019; 30:32-5
  • Genidy MM, Abdelghany AA, Alio JL. Tailored corneo-conjunctival autografting in primary and secondary pterygium surgery. Eur J Ophthalmol. 2017;27(4):407-10.
  • Das P, Gokani A, Bagchi K, Bhaduri G, Chaudhuri S, Law S. Limbal epithelial stem-microenvironmental alteration leads to pterygium development. Mol Cell Biochem. 2015;402(1-2):123-39.
  • Al Fayez MF. Limbal versus conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 2002;109(9):1752-5.
  • Dekaris I, Gabrić N, Karaman Z, Mravicić I, Kastelan S. Limbal-conjunctival autograft transplantation for recurrent pterygium. Eur J Ophthalmol. 2002;12(3):177-82.
  • Katircioğlu YA, Altiparmak UE, Duman S. Comparison of three methods for the treatment of pterygium: amniotic membrane graft, conjunctival autograft and conjunctival autograft plus mitomycin C. Orbit. 2007;26(1):5-13.
  • Li M, Zhu M, Yu Y, Gong L, Zhao N, Robitaille MJ. Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2012;250(3):375-81.
  • Toker E, Eraslan M. Recurrence After Primary Pterygium Excision: Amniotic Membrane Transplantation with Fibrin Glue Versus Conjunctival Autograft with Fibrin Glue. Curr Eye Res. 2016;41(1):1-8.
  • Tananuvat N, Martin T. The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft. Cornea. 2004;23(5):458-63.
  • Pan X, Zhang D, Jia Z, Chen Z, Su Y. Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium. BMC Ophthalmol. 2018;18(1):119.
  • 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 (Lond). 2008;22(3):420-4.
  • Mutlu FM, Sobaci G, Tatar T, Yildirim E. A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology. 1999;106(4):817-21.
  • Demircan A. Conjunctival limbal autograft implantation in primary and recurrent pterygium. Beyoglu Eye J 2018; 3(2): 71-4
  • Song JJ, Finger PT, Kurli M, Wisnicki HJ, Iacob CE. Giant secondary conjunctival inclusion cysts: a late complication of strabismus surgery. Ophthalmology. 2006;113(6): 1049.e1-2.
  • Lee JS, Ha SW, Yu S, Lee GJ, Park YJ. Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium. Korean J Ophthalmol. 2017;31(6):469-78.
  • Harmancı Ç. The results of conjunctivolimbal autograft transplantation in primary pterygium. Dicle Med Journal. 2013;40(3):469–73.

Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız

Year 2020, Volume: 9 Issue: 2, 41 - 46, 31.08.2020
https://doi.org/10.47493/abantmedj.2020.6

Abstract

GİRİŞ ve AMAÇ: Primer ve rekürren pterjiyumlu olgularda gerçekleştirdiğimiz limbal konjonktival otogreft transplantasyonu (LCAT) sonuçlarını değerlendirmek.
YÖNTEM ve GEREÇLER: Çalışmaya 38 hastanın 42 gözü dahil edildi. Bunlardan 26’sı primer iken 16’sı rekürren pterjiyumdu. Tüm gözlere pterjiyum eksizyonu ile birlikte limbal konjonktival otogreft transplantasyonu uygulandı. En az 12 ay boyunca takip edilen hastalar, demografik veriler, pterjiyum evresi, cerrahi komplikasyonlar, nüks oranı, refraktif astigmatizma ve görme keskinliği açısından değerlendirildi.
BULGULAR: Hastaların ortalama yaşı 44 ± 8.5 idi. Hastaların 26’sı (% 68.4) hasta erkek, 12'si (% 31.6) kadındı. Primer pterjium grubunda nüks görülmezken, tekrarlayan pterjium grubunda iki nüks gözlendi. Toplam nüks oranı %4.7 idi. Üç hastada greft oluşturulurken düğme iliği (buttonhole) komplikasyonu meydana geldi. Rekürren pterjiyumlu 2 hastada konjonktival inklüzyon kisti gelişti.
TARTIŞMA ve SONUÇ: Hem primer hem de rekürren pterjiyum tedavisinde limbal konjonktival otogreft transplantasyonu etkili ve güvenilir bir cerrahi seçenek olarak gözükmektedir.

References

  • Young AL, Cao D, Chu WK, Ng TK, Yip YWY, Jhanji V, Pang CP. The Evolving Story of Pterygium. Cornea. 2018;37 Suppl 1: 55-7.
  • Saw SM, Tan D. Pterygium: prevalence, demography and risk factors. Ophthalmic Epidemiol. 1999;6(3):219-28.
  • Süren E, Uçakhan Gündüz ÖÖ, Kanpolat A. Pterjium Tedavisinde Yenilikler. MN Oftalmol. 2010;17(1):71–7.
  • Fernandes M, Sangwan VS, Bansal AK, Gangopadhyay N, Sridhar MS, Garg P, Aasuri MK, Nutheti R, Rao GN. Outcome of pterygium surgery: analysis over 14 years. Eye (Lond). 2005;19(11):1182-90.
  • Daya SM. Conjunctival-limbal autograft. Curr Opin Ophthalmol. 2017;28(4):370-6.
  • Donepudi GD, Ramesh S, Govindarajulu M, Dhanasekaran M, Moore T, Ganekal S, Hiremath CS. Early postoperative outcomes of pterygium surgery: Sutures versus autogenous serum in-situ fixation of limbal conjunctival autograft. Life Sci. 2019; 221:93-8.
  • Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol. 1997;115(10):1235-40.
  • Jaworski CJ, Aryankalayil-John M, Campos MM, Fariss RN, Rowsey J, Agarwalla N, Reid TW, Dushku N, Cox CA, Carper D, Wistow G. Expression analysis of human pterygium shows a predominance of conjunctival and limbal markers and genes associated with cell migration. Mol Vis. 2009; 15:2421-34.
  • Bhargava P, Kochar A, Joshi R. Pterygium excision followed by sutureless and gluefree infero-temporal conjunctival autograft. DJO 2019; 30:32-5
  • Genidy MM, Abdelghany AA, Alio JL. Tailored corneo-conjunctival autografting in primary and secondary pterygium surgery. Eur J Ophthalmol. 2017;27(4):407-10.
  • Das P, Gokani A, Bagchi K, Bhaduri G, Chaudhuri S, Law S. Limbal epithelial stem-microenvironmental alteration leads to pterygium development. Mol Cell Biochem. 2015;402(1-2):123-39.
  • Al Fayez MF. Limbal versus conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 2002;109(9):1752-5.
  • Dekaris I, Gabrić N, Karaman Z, Mravicić I, Kastelan S. Limbal-conjunctival autograft transplantation for recurrent pterygium. Eur J Ophthalmol. 2002;12(3):177-82.
  • Katircioğlu YA, Altiparmak UE, Duman S. Comparison of three methods for the treatment of pterygium: amniotic membrane graft, conjunctival autograft and conjunctival autograft plus mitomycin C. Orbit. 2007;26(1):5-13.
  • Li M, Zhu M, Yu Y, Gong L, Zhao N, Robitaille MJ. Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2012;250(3):375-81.
  • Toker E, Eraslan M. Recurrence After Primary Pterygium Excision: Amniotic Membrane Transplantation with Fibrin Glue Versus Conjunctival Autograft with Fibrin Glue. Curr Eye Res. 2016;41(1):1-8.
  • Tananuvat N, Martin T. The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft. Cornea. 2004;23(5):458-63.
  • Pan X, Zhang D, Jia Z, Chen Z, Su Y. Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium. BMC Ophthalmol. 2018;18(1):119.
  • 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 (Lond). 2008;22(3):420-4.
  • Mutlu FM, Sobaci G, Tatar T, Yildirim E. A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology. 1999;106(4):817-21.
  • Demircan A. Conjunctival limbal autograft implantation in primary and recurrent pterygium. Beyoglu Eye J 2018; 3(2): 71-4
  • Song JJ, Finger PT, Kurli M, Wisnicki HJ, Iacob CE. Giant secondary conjunctival inclusion cysts: a late complication of strabismus surgery. Ophthalmology. 2006;113(6): 1049.e1-2.
  • Lee JS, Ha SW, Yu S, Lee GJ, Park YJ. Efficacy and Safety of a Large Conjunctival Autograft for Recurrent Pterygium. Korean J Ophthalmol. 2017;31(6):469-78.
  • Harmancı Ç. The results of conjunctivolimbal autograft transplantation in primary pterygium. Dicle Med Journal. 2013;40(3):469–73.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Mustafa Kalaycı

Ersan Çetinkaya

Elçin Süren

Mehmet Fatih Küçük

Kenan Yiğit

Deniz Turgut Coban

Publication Date August 31, 2020
Submission Date March 22, 2020
Published in Issue Year 2020 Volume: 9 Issue: 2

Cite

APA Kalaycı, M., Çetinkaya, E., Süren, E., Küçük, M. F., et al. (2020). Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız. Abant Medical Journal, 9(2), 41-46. https://doi.org/10.47493/abantmedj.2020.6
AMA Kalaycı M, Çetinkaya E, Süren E, Küçük MF, Yiğit K, Turgut Coban D. Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız. Abant Med J. August 2020;9(2):41-46. doi:10.47493/abantmedj.2020.6
Chicago Kalaycı, Mustafa, Ersan Çetinkaya, Elçin Süren, Mehmet Fatih Küçük, Kenan Yiğit, and Deniz Turgut Coban. “Primer Ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız”. Abant Medical Journal 9, no. 2 (August 2020): 41-46. https://doi.org/10.47493/abantmedj.2020.6.
EndNote Kalaycı M, Çetinkaya E, Süren E, Küçük MF, Yiğit K, Turgut Coban D (August 1, 2020) Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız. Abant Medical Journal 9 2 41–46.
IEEE M. Kalaycı, E. Çetinkaya, E. Süren, M. F. Küçük, K. Yiğit, and D. Turgut Coban, “Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız”, Abant Med J, vol. 9, no. 2, pp. 41–46, 2020, doi: 10.47493/abantmedj.2020.6.
ISNAD Kalaycı, Mustafa et al. “Primer Ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız”. Abant Medical Journal 9/2 (August 2020), 41-46. https://doi.org/10.47493/abantmedj.2020.6.
JAMA Kalaycı M, Çetinkaya E, Süren E, Küçük MF, Yiğit K, Turgut Coban D. Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız. Abant Med J. 2020;9:41–46.
MLA Kalaycı, Mustafa et al. “Primer Ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız”. Abant Medical Journal, vol. 9, no. 2, 2020, pp. 41-46, doi:10.47493/abantmedj.2020.6.
Vancouver Kalaycı M, Çetinkaya E, Süren E, Küçük MF, Yiğit K, Turgut Coban D. Primer ve Rekürren Pterjiyumlarda Limbal Konjonktival Otogreft Transplantasyonu Sonuçlarımız. Abant Med J. 2020;9(2):41-6.