Abstract
Purpose: :
To report a new technique to reduce the recurrence of pterygium and symblepharon after pterygium excision.
Methods: :
Retrospective Case Review
Results: :
Three patients were identified, with a history of recurrent pterygium, managed using an identical two-staged excision technique. Of these patients, one had pre-existing symblephara. Two patients had a previous history of bilateral pterygium excision in South America greater than 10 years prior to presentation. The third patient had bilateral pterygia both nasally and temporally with limitation of lateral gaze in both eyes, as well as a history of bilateral excision twice in Brazil over 15 years. All patients underwent pterygium excision using adjuvant Mitomycin C and Amniotic membrane graft, with subsequent placement of Prokera (BioTissue, Inc. Miami, Florida) 1 week post-operatively. One-year post surgical excisions using this technique, two patients have yet to develop corneal recurrence or symblepharon. The third patient developed recurrence of the pterygium and symblepharon six months post-operatively, but with further investigation was thought to have severe cicatricial disease.
Conclusions: :
A two-staged technique for pterygium excision using Mitomycin C, Amniotic Membrane, and Prokera may be an alternative method to prevent corneal recurrence as well as reduce symblepharon formation. Treatment effectively may be limited in those patients with more severe ocular cicatricial disease, though this method may still delay time-to-recurrence.