June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Recurrence Rate of Narrow Strip Limbal Conjunctival Autograft with Amniotic Membrane Graft versus traditional Conjunctival Autograft alone for Treatment of Primary Pterygium
Author Affiliations & Notes
  • Shaily Dinesh Shah
    Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Allison Rizzuti
    Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Anika Michael
    Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Ari Weitzner
    Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Stephen Kaufman
    Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York, United States
  • Footnotes
    Commercial Relationships   Shaily Shah, None; Allison Rizzuti, None; Anika Michael, None; Ari Weitzner, None; Stephen Kaufman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5698. doi:
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      Shaily Dinesh Shah, Allison Rizzuti, Anika Michael, Ari Weitzner, Stephen Kaufman; Recurrence Rate of Narrow Strip Limbal Conjunctival Autograft with Amniotic Membrane Graft versus traditional Conjunctival Autograft alone for Treatment of Primary Pterygium. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5698.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There are many surgical technqiues to remove pterygia. The gold standard has involved the placement of a conjunctival autograft on the bare-scleral bed. Another technique, involving construction of an autologous conjunctival strip which spares the superior conjunctiva, has been used as an alternative type of conjunctival graft. This study compares the efficacy of a narrow strip limbal conjunctival autograft together with amniotic membrane graft (NS-CAT + AMG) to that of traditional conjunctival autograft technique (CAT).

Methods : In this retrospective study, 15 eyes of 15 patients with primary pterygium were treated with excision followed by NS-CAT + AMG, while 13 eyes from 13 patients with primary pterygium were treated with excision with CAT. Primary outcome measured was recurrence greater than 1mm past the limbus at six months post-operatively. Secondary outcomes included best corrected visual acuity (BCVA) and complications such as dry eye syndrome and pyogenic granuloma six months post-operatively.

Results : Nine patients (60%) in the NS-CAT + AMG group experienced recurrent pterygium at six month follow up, compared to significantly fewer patients (0%) in the CAT group (p = 0.00396). Interestingly, no statistically significant difference was found in the number of patients experiencing dry eye syndrome (p = 0.511) or pyogenic granulomas (p = 0.191), and no difference was found in the number of lines of improvement in BCVA (p = 0.367) between the two treatment groups at six month follow up.

Conclusions : Prior studies note narrow strip conjunctival autograft to be an effective procedure with low recurrence rates (with or without combined amniotic membrane graft); however to our knowledge this study is the first to compare NS-CAT + AMG to the traditional CAT technique for pterygium excision. We conclude that compared to CAT, NS-CAT + AMG leads to higher rates of recurrence when used in patients for primary pterygium excision.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Narrow Strip Limbal Conjunctival Autograft. (A) Nasal pterygium (B) Bare sclera after pterygium excision. (C) Harvesting of narrow strip conjunctival autograft. (D) Rotation of conjunctival autograft to limbal edge of bare sclera. (E) Placement of amniotic membrane graft over remaining bare sclera. (F) Placement of bandage contact lens over conjunctival autograft and amniotic membrane graft.

Narrow Strip Limbal Conjunctival Autograft. (A) Nasal pterygium (B) Bare sclera after pterygium excision. (C) Harvesting of narrow strip conjunctival autograft. (D) Rotation of conjunctival autograft to limbal edge of bare sclera. (E) Placement of amniotic membrane graft over remaining bare sclera. (F) Placement of bandage contact lens over conjunctival autograft and amniotic membrane graft.

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