Abstract
Purpose :
To evaluate a novel, sutureless, and glueless surgical technique using a triple-layer dehydrated amniotic membrane (TLDAM) for pterygia excisions in terms of surgical time and postoperative pain, epiphora, irritation, and foreign body sensation.
Methods :
Twenty eyes of eighteen patients with pterygia underwent pterygia excision with mitomycin C. The conjunctival defect was closed with a sutureless, glueless technique with TLDAM placed directly on the dried scleral bed with the edges of the amniotic membrane tucked under the edges of the conjunctival defect. Surgical times were measured from injection of lidocaine to final placement of bandage contact lens.
Immediately postoperatively, a bandage contact lens was placed, and the eye was patched until postoperative day 1. Subsequently, patients graded self-administered questionnaires to rate pain, foreign body sensation (FBS), irritation, and watering on a scale of 1-5 (1-none; 5-most severe) at postoperative day 1 (POD1) and week 1 (POW1).
Results :
Surgical times range from 6:55 to 12:00, with a mean of 8:29. Compared with a previous study of also sutureless and glueless methodology, the difference in surgical time means is 11.9 (p < 0.0001). Mean questionnaire scores for each postoperative visit were as follows: POD1 Pain 1.8, FBS 2.3, irritation 1.0, and epiphora 2.6; POW1 Pain 1.5, FBS 1.6, irritation 1.6, and epiphora 1.6. Compared to previous studies, this technique showed statistically significant improved pain at POD1 (p=.0086, p<.0001, p<.0001, p<.0001) and POW1 (p=.0354, p=.0002, p=.0016, p<.0001). Improvement in foreign body sensation was also noted at POD 1 (p=.0321, p<.0001). See table for full statistical analysis.
Conclusions :
The sutureless, glueless technique using Cellularity TLDAM is a safe and effective surgical technique compared to current standard methods. There appears to be a significant benefit regarding surgical time and postoperative pain, irritation, epiphora, and foreign body sensation compared to previous studies.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.