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J.N. Murta, M. Quadrado, P. Fonseca, R. Faria; Limbal Conjunctival Autograft Transplantation After Extensive Removal of Primary and Recurrent Pterygium . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4968.
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Purpose: An ideal pterygium surgery should have a low recurrence rate, lack of complications and a satisfactory cosmetic appearance. A variety of surgical procedures have been described for the treatment of pterygium; however, recurrence remains a significant problem. The purpose of this work was to evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating advanced and recurrent pterygium. Methods: 63 eyes of 60 patients with either primary (Group I; n= 34) or recurrent (Group II; n=29) ptergium were operated with an extensive excision of the lesion by blunt dissection, extensive removal of subconjuntival fibrovascular tissue followed by limbal conjuntival autograft transplantation. Topical steroids were used during 4–7 weeks. The main outcomes were: recurrence of pterigium according to a grading system on a scale of 1 to 4 (grade 1 – normal appearance; grade 2 – presence fine episcleral vessels in excised area, extending to the limbus, but without any fibrous tissue; grade 3 – fibrovascular tissue in excised area, reaching to the limbus but not invading the cornea; grade 4 – true corneal recurrence, with fibrovascular tissue invading the cornea). Follow–up ranged from 6 months to 3 years. Results: 62 eyes had a rapid anatomical and functional recovery with excellent cosmetic results. Visual acuity increased in 5 eyes and remained unchanged in 58 eyes. In 6 cases (9.5 %) – 1 from group I (2.9 %) and 5 from group II (17.2%) – we observed a grade 4 of recurrence. The surgical technique will be presented. Conclusions: Limbal conjunctival autograft transplantation is an effective and safe procedure for pterygium surgery with a very low recurrence rate for both advanced primary and recurrent pterygium.
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