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Optimal size of pterygium excision for limbal conjunctival autograft using fibrin
glue in primary pterygia
#MMPMID29879926
Hwang HS
; Cho KJ
; Rand G
; Chuck RS
; Kwon JW
BMC Ophthalmol
2018[Jun]; 18
(1
): 135
PMID29879926
show ga
BACKGROUND: In our study we describe a method that optimizes size of excision and
autografting for primary pterygia along with the use of intraoperative MMC and
fibrin glue. Our objective is to propose a simple, optimizedpterygium surgical
technique with excellent aesthetic outcomes and low rates of recurrence and
otheradverse events. METHODS: Retrospective chart review of 78 consecutive
patients with stage III primary pterygia who underwent an optimal excision
technique by three experienced surgeons. The technique consisted of removal of
the pterygium head, excision of the pterygium body and Tenon's layer limited in
proportion to the length of the head, application of intraoperative mitomycin C
to the defect, harvest of superior bulbar limbal conjunctival graft, adherence of
graft with fibrin glue. Outcomes included operative time, follow up period,
pterygium recurrence, occurrences of incorrectly sized grafts, and other
complications. RESULTS: All patients were followed up for more than a year. Of
the 78 patients, there were 2 cases of pterygium recurrence (2.6%). There was one
case of wound dehiscence secondary to small-sized donor conjunctivaand one case
of over-sized donor conjunctiva, neither of which required surgical correction.
There were no toxic complications associated with the use of mitomycin C.
CONCLUSION: Correlating the excision of the pterygium body and underlying Tenon's
layer to the length of the pterygium head, along with the use intraoperative
mitomycin C, limbal conjunctival autografting, and fibrin adhesionresulted in
excellent outcomes with a low rate of recurrence for primary pterygia.
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