Abstract
Purpose: :
The main difficulty in surface ocular disease is the functional replace of normal tissue. The biomembrane latex (BL) is biocompatible and promotes tissue neoformation. Our purpose was to compare the action in ocular surface between BL and authologous conjunctival autograft (CA) in rabbits and humans eyes. To better comparisons, we purpose a new method of postoperative evaluation based on fibrovascular tissue growing.
Methods: :
BL (group A) and CA (group B) was applied over bare sclera in nine New Zealand rabbits. The rabbits were sacrificed to histological analysis in seven, fourteen and twenty-one days. The principal outcomes were inflammation and its cellularity, epithelization, epithelial layer, stromal thickness and globbet cells. Later on, BL and CA were applied immediately after pterygium surgery. 85 patients underwent BL group and 42 in CA group. The patients were followed by one year. The BL and all the sutures were removed at 14th day postoperative in rabbits and humans. The fibrovascular tissue growing and recurrence (≥ 1,5mm over cornea) were measured at 3, 6 and 12 months.
Results: :
In rabbits, the group A showed more inflammation at 7 days. At 14 days, the main difference between them was the globet cells, easily seen in group B. The groups were similar at 21 days. In pterygium study, there was no significant difference between groups in age, sex and symptoms. Dellen was most frequently seen in CA group (p = 0,03). BL and TC group were similar about recurrences, 40,7% and 30%, respectively (p = 0,318). In the Kaplan-Meier survival analysis, it was impossible to note significant difference between groups (p = 0,20). The fibrovascular tissue growing measure at 3, 6 and 12 months from BL group were greater than TC group (p<0,01, p < 0,01 e p = 0,001, respectively). That indicates BL group tendency to pterygium recurrence, poor aesthetic outcome and compatible symptoms in long term observation.
Conclusions: :
This study proposes the fibrovascular tissue growing measure like an auxiliary method of postoperative evaluation. BL seems to be efficient in ocular surface reconstruction and must be employed in future studies of other pathologies. This material revealed to be a new source of therapeutic resort to external eye diseases and conjunctival replace in surgeries living bare sclera.
Clinical Trial: :
http://www.clinicaltrials.gov NCT01250353
Keywords: conjunctiva • wound healing • pterygium