Minor Ipsilateral Simple Limbal Epithelial Transplantation (Mini-SLET) for Pterygium Treatment

Abstract

 

Purpose

 

To describe a novel surgical technique for pterygium removal taking advantage of the properties of the amniotic membrane and limbal epithelial stem cells.

 

Methods

 

A total of 13 patients with primary, recurrent or mixture pterygium, with nasal or temporal location underwent a resection of pterygium with conventional technique. The bare sclera was covered with an amniotic membrane with fibrin sealant. Resection of 2x2 mm of limbal epithelial stem cells at the superior or inferior palisades of Vogt was performed. The epithelial limbal strip was cut into 8-10 pieces and placed in a linear fashion in the affected limbal area being covered with a second amniotic membrane in a sandwich technique with the use of fibrin sealant. Finally a soft contact lens was left in place.

 

Results

 

After 4 months of follow-up, all patients were fully epithelialised with a complete adaptation of the amniotic membrane. The epithelial limbal stem cells remained in place and became transparent. There were neither sight threatening complications nor early signs of recurrence.

 

Conclusions

 

This technique requires less tissue than the conventional conjunctival autograft and offers the advantages of epithelial stem cells, which in a long-term may reduce the rate of recurrence significantly.  

 

Preoperative and postoperative clinical photographs of 2 eyes that underwent mini-SLET. A, preoperative photograph of a 47-year-old male carpenter (case 9) with a history of bilateral pterygium. B, 1 day alter the surgery. C, 1 week. D, 1 month. E, 3 months. F, Preoperative photograph of a 26-year-old student (case 6) with bilateral pterygium, the mini-SLET was performed in the temporal lesion. G, 1 day after the surgery. H, 1 week. I, 1 month. J, 3 months.