| Abstract: |
Despite the various surgical procedures that have been described for the treatment of pterygium, recurrence remains a significant problem after surgical excision. Recurrence rates range from 24% to 89% after simple excision with bare sclera technique. Adjunctive therapies aiming at suppressing regrowth of subconjunctival tissue, such as irradiation, thiotepa, and topical postoperative mitomycin C, have succeeded in decreasing the number of recurrences to between 0% and 12%. However, serious complications are associated with these methods of treatment, such as disfiguring skin depigmentation, cataract formation, severe secondary glaucoma, uveitis, corneal perforation, and scleral necrosis, resulting in perforation and secondary endophthalmitis. An intraoperative single dose of low concentration mitomycin C was effective in reducing recurrence while diminishing the risk of serious complications. However, long-term risks of mitomycin C are still unknown, and corneoscleral melt, although rare, was reported after a single dose of intraoperative mitomycin C. In 1985, Kenyon et al described their procedure ofconjunctival autograft for the management of recurrent or advanced pterygium with a low recurrence rate of 5.3%. Although more time consuming, this surgical technique was found to be safe and effective in reducing the number of recurrences while avoiding the risk of potentially serious complications. However, studies performed in high-risk populations observed higher recurrence rates using the same surgical technique.Recent studies have reported the effectiveness of limbal conjunctival autograft transplantation in the prevention of recurrence of pterygia. Amniotic membrane transplantation has recently been proposed as a treatment option. Various conjunctival autografting techniques have been previously described including both mini conjunctival autograft and wide (P.E.R.F.E.C.T) typeIn this study 40 cases, 24 eyes with primary ptergiyum (60%) & 16 eyes with recurrent ptergiyum (40%).Patients were divided into 4 groups each group consists of 10 eyes:• Group A: LCAG.• Group B: CG.• Group C: AM graft.• Group D: modified CG, 5 eyes had mini conjunctival auto graft, the other 5 eyes had the P.E.R.F.E.C.T (pterygium extended removal followed by extended conjunctival transplantation) technique.Patients were operated under both topical & infiltration anaesthesia. Either retro-bulbar or peribulbar . The follow up were on 1st post operative day, 1st week, 1st month, 6th month & after 1 year. The post operative follow up data were carried out with particular attention to the symptomatic complaints of the patients, visual acuity & slit-lamp biomicroscopy. A recurrence was a main point for documentation during the whole course of the study.
|
|
|