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J. Liu, H. Sheha, S. C. G. Tseng; A New Surgical Technique to Prevent Recurrence and Restore Ocular Motility in Multi-Recurrent Pterygia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2407.
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To describe a new surgical technique of closing the gap between conjunctiva and Tenon’s capsule with fibrin glue and anchoring sutures so as to prevent recurrence and restore ocular motility.
The surgical procedure involved lysis of cicatrix from the symblepharon, recess the conjunctiva to the fornix, sealing the gap between the conjunctiva and the residual healthy Tenon with fibrin glue, and passing a double-armed 4-0 black silk mattress anchoring suture to the skin so that the sealed tissue is moved away from the sclera. The final reconstruction was completed using amniotic membrane transplantation with fibrin glue to cover the muscle, the bare sclera, and the fornix.
In a total of 19 eyes with multi-recurrent pterygia with recurrent times range from 1 - 5 (mean 1.7), 14 (73.7%) eyes also had restrictive diplopia. The above surgical procedure prevented recurrence in all 19 eyes, and restored a full range of ocular motility in 12 (85.7%) eyes and partially in 2 (14.3%) eyes. Patients also recovered a smooth and stable ocular surface with an elevated caruncle and a deep fornix without any complication.
Closing the gap between the conjunctiva and the Tenon’s capsule by this new surgical procedure plays an important role to prevent recurrence and restore ocular motility in multi-recurrent pterygia. This surgical approach may also be applied to primary pterygium and other cicatricial eye diseases.
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