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Hongshan Liu; Ocular surface epithelial wound healing after pterygium excision. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2755.
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Pterygium is a common ocular disorder in many parts of the world. Currently, there is a wide variety of surgical method to prevent the recurrence of pterygium after surgeries, but the change of ocular surface epithelial cells is uncompletely explained, and even it is unclear between ocular surface epithelial wound healing and pterygium recurrence. Therefore, we examined the characteristics of ocular surface epithelial cells after pterygium surgeries.
Sixty-eight patients with a primary pterygium of 2 to 7 mm in size and without any previous ocular surgery received a pterygium excision with or without limbal-conjunctival or dehydration-preserved amniotic membrane transplantation. At different time points, ocular surface epithelial cells of surgical region were collected by cytological impression of excision-involved area of cornea and conjunctiva. The samples were fixed in 1% paraformaldehyde and immunostained by the antibody against Keratin 12, 13, and 19. Moreover, pterygium recurrence was also investigated.
Following the surgery, corneal epithelial defect was respectively recovered at 2.11 ± 0.99, 2.51 ± 1.2, and 1.63 ± 0.77 days after the pterygium excision without or with amniotic membrane or limbal-conjunctival transplantation (p < 0.05) and conjunctival recovery of excision area was respectively performed at 0, 4.89 ± 1.66, and 0 days after simple excision, the pterygium removal with amniotic membrane or limbal-conjunctival transplantation (p < 0.01). Impression cytology revealed, surgery-involved corneal area was recovered by Keratin 12-positive cells following three surgery types and conjunctival excision region was always covered by Keratin 13 and 19-positive cells after a simple pterygium excision and excision combined with limbal-conjunctival transplantation. However, surgery-involved conjunctival area was recovered by Keratin 12, 13, and 19-positive cells until 6 weeks after pterygium excision with limbal-conjunctiva transplantation; afterwards, this region was occupied by Keratin 13 and 19-positive cells. The recurrence rate was respectively 20.3%, 8.4%, and 4.5% at 6 months follow-up after simple excision, the pterygium removal with amniotic membrane or limbal-conjunctival transplantation (p < 0.01).
Corneal epithelial cells participate conjunctival epithelial wound healing after pterygium excision in the early stage.
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