Abstract
Background
Treatment of eyes with multirecurrent pterygia associated with severe symblepharon and motility restriction is challenging. A combined surgical procedure of intraoperative mitomycin C, amniotic membrane transplantation and conjunctival limbal autograft was applied for treating such eyes.
Methods
Seven eyes of seven patients who had previously undergone an average of four operations for pterygial removal and who manifested recurrent pterygia associated with severe symblepharon and motility restriction were involved in this retrospective study. The surgical procedures involved clearing fibrovascular membrane over the cornea, extensive excision of epibulbar fibrovascular tissue to the bare sclera, application of 0.02% mytomycin C onto the bare sclera for 5 min and transplantation of preserved human amniotic membrane and conjunctival limbal autograft.
Results
Postoperatively, all seven eyes showed rapid epithelialization on the corneal surface in 3–5 days and, on the conjunctival surface, in 10–18 days. For a mean follow-up period of 22.4±6.1 months, six eyes recovered deep fornices, smooth and stable ocular surface and full ocular motility without recurrence. One eye showed regrowth of fibrovascular tissue and motility restriction but less severe than before surgery. No complication was noted due to mitomycin C.
Conclusions
Combined intraoperative mitomycin C, amniotic membrane graft and limbal conjunctival autograft are successful approaches for treating multirecurrent pterygia with severe symblepharon to restore the ocular surface integrity and prevent recurrence.
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S.C.G.T. and his family are more than 5% shareholders of TissueTech, Inc., which owns US Patents nos 6,152,142 and 6,326,019 on the method of preparation and clinical uses of human amniotic membrane.
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Yao, YF., Qiu, WY., Zhang, YM. et al. Mitomycin C, amniotic membrane transplantation and limbal conjunctival autograft for treating multirecurrent pterygia with symblepharon and motility restriction. Graefe's Arch Clin Exp Ophthalmo 244, 232–236 (2006). https://doi.org/10.1007/s00417-005-0010-y
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DOI: https://doi.org/10.1007/s00417-005-0010-y