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J. Kim, J. Lee, Y. Song, Y. Kwon, M. Shin; Amniotic Membrane Patch Reduces Pain and Recurrence Rate After Pterygium Removal . Invest. Ophthalmol. Vis. Sci. 2005;46(13):953.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Bone marrow–derived stem cells (BMSCs) involved in wound healing via both systemic and local chemotactic factors after pterygium removal and pain acts as a trigger signal. Temporary amniotic membrane patch (TAMP) could reduce pain and recurrence rate. Methods:Post–operative pain and recurrence rate in TAMP (n=62) and bare sclera excision groups (BS, n=57) were compared over 12 month period. Substance–P (SP), a pain–related neuropeptide, and related VEGF and SCF were measured both in serum and tear using ELISA and migrating CD34+ and c–kit+ mononuclear cells (MNCs) by flow cytometry. BMSCs and SP absorbed in TAMP were confirmed by immunohistochemistry. Correlation between chemotactic factors and migrating BMSCs were analyzed statistically. Results: In TAMP group, 30.6% of patients experienced a foreign body sensation or mild pain with marked decrease in serum SP whereas 94.7% complained of severe pain with markedly increased SP in BS group (pain: p<0.05, SP: p<0.05). The systemic and local VEGF, SCF showed a similar pattern to SP in serum (p<0.05; VEGF, p<0.01; SCF, respectively). In contrast to BS group, CD34+MNCs count was not increased in TAMP group after surgery (5.19% p=0.62 VS. 22.3%, p<0.05, respectively). Decreased systemic SP and CD34+MNCs showed a close correlation in TAMP group showed close relationship (r=0.91, p<0.05). BMSCs infiltration was confirmed with removed TAMP. Conclusions: Clinically, these results have led to a markedly lowering of recurrence rate in TAMP group (TAMP: 3.2%, BS: 15.8%, p<0.05, respectively). TAMP might be an effective procedure for preventing recurrence of pterygium.
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