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Hiroki Kawano, Koji Kawano, Taiji Sakamoto; Primary Pterygium Surgery by Separate Limbal-conjunctival Autograft transplantation from Inferior Conjunctiva. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4022.
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Inferior limbal-conjunctival autograft transplantation has been described as a safe and effective treatment for primary pterygium. However,despite its multiple advantages, routine performance of this technique is difficult because the inferior conjunctiva is often too small to provide enough autograft material. To resolve this issue, we modified a technique inferior separate limbal-conjunctival autograft transplantation and evaluated its efficacy and safety.
Cases were retrospectively reviewed from the medical record. The surgery consisted of a thorough pterygium excision followed by 0.02% mitomycin C application. Next, we performed inferior conjunctival autografting, in which limbal and bulbar conjunctival autografts were independently harvested and secured to the denuded limbus and the most posterior conjunctival defect at the pterygium excision site to ensure stem cell restoration and deep fornix reconstruction, respectively; the bare sclera between the two grafts was exposed. The outcome was assessed with a three-point grading scale at the patient’s last visit.
A total of 50 eyes were included. The success and recurrence rates were 96.0% (48 of 50) and 0%, respectively, assessed at follow-ups occurring at a mean of 19.2 ± 5.6 months af ter surgery. Only minimal complications were encountered.
A combination of inferior separate limbal-conjunctival autograft transplantation with intraoperative 0.02% mitomycin C application is a safe and effectivetechnique enabling the routine use of under-sized autografts harvested from the inferior conjunctiva after thorough pterygium excision.
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