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Seung Hoon Yoo, Jin Kwon Chung; Angiographic Characteristics of the Pterygia and Restoration of the Structure After Limbal Conjunctival Autograft Transplantations. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3047.
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© ARVO (1962-2015); The Authors (2016-present)
Pterygia recently have been thought to originate from limbal stem cells. In past, few studies have evaluated the angiographic features of the affected limbus. We studied prospectively to evaluate the perioperative angiographic features of the limbus in patients with pterygia and assessed limbal reconstruction after limbal-conjunctival autograft (LCA) transplantation in terms of vascular remodeling.
Thirty one eyes with pterygium of 31 patients and sound eyes of 28 normal participants were enrolled in this study. To investigate the angiographic characteristics of the pterygium, indocyanine green angiography (ICGA) was performed for each participant preoperatively and at 1 week, and 1 and 3 months postoperatively. The perioperative angiographic features of the pterygium were compared with control group. The structural changes of the Marginal corneal vascular arcades (MCAs) and LCA were quantitatively assessed postoperatively in terms of vascular density and lacunarity using a semiautomated computational tool(AngioTool).
Deteriorated MCAs that extended beyond the pterygium head were observed in the pterygium group. The pterygium had a dual blood supply from the conjunctival and episcleral circulations. In terms of limbal reconstruction, the engorged reperfusion vessels arose from the adjacent episcleral vessels along the limbus at 1 week postoperatively. The reconstructed MCAs had begun to appear at 1 month postoperatively and became apparent 3 months postoperatively in 26 (83.9%) of 31 eyes of the pterygium group, resulting in a successful clinical outcome. Higher vascular density and lower lacunarity were measured in the limbus and the graft at 3 months than at 1 month (P < 0.001 for all), which indicated fine reorganization of the reconstructed vessels.
The MCAs were deteriorated in the affected limbus, and the pterygium head had a dual blood supply from the conjunctival and episcleral circulations. The remodeling of the LCA and affected limbus continued up to 3 months postoperatively.
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