Hongseok Yang, MD

Department of Ophthalmology, Ajou University School of medicine, Suwon, Korea

The author has no financial interest

PurposeTo evaluate the efficacy of conjunctival autograft

transplantation with amniotic membrane transplantation in primary pterygium surgery

To compare postoperative recurrence rates between conjunctival autograft transplantation only and conjunctival autograft transplantation with amniotic membrane transplantation in primary pterygium surgery.

Patients and methodsPatients with pterygium who underwent conjunctival

autograft transplantationFrom January, 2001 to May, 2009 in Department of

ophthalmology, Ajou university medical center

Single surgeon

Retrospective study, chart review

Patients and methods

2 groups (66 eyes of 63 patients)Group 1: conjunctival autograft transplantation only

23 eyes of 22 patients

Group 2: conjunctival autograft transplantation with amniotic membrane transplantation 43 eyes of 40 patients

Patients and methods Removal of pterygium from cornea with Beaver blade.

Patients and methods Tenon and subconjunctival fibrovascular tissue were undermined

and excised extensively with a pair of spring scissors.

Patients and methods Marked the donor conjunctiva with Gentian violet made to

measure the size of conjunctival defect.

Patients and methodsConjunctival graft was attached to the conjunctival edges and

episclera with interrupted 10–0 Nylon sutures

Patients and methodsAmniotic membrane was cut a proper-sized graft, which would

cover the conjunctival transplantation area and corneal epithelial defect area. The membrane was placed over the epithelial side on top. Pinch together the membrane and conjunctiva, interrupted suture was done with 10-0 Nylon.

ResultsM:F = 9:13 (group 1)

17:23 (group 2)

Average follow up period

group 1 : 11.7 ± 24.2 month

group 2 : 12.4 ± 16.8 month

Average recurrence interval

group 1 : 3.2 (1 – 4)month

group 2 : 5 (4- 6)month

ResultsRecurrence of pterygium was observed in 5 of 23 eyes that

received conjunctival autograft transplantation only. (21.7%)

Recurrence of pterygium was observed in 2 of 43 eyes that

received conjunctival autograft transplantation and amniotic

membrane transplantation.(4.6%)

Therer is a statistically significant difference between two groups.

(p<0.05)

No major complications such as necrotizing scleritis, sclera ulcer,

corneal perforation were noted in either group after surgery.

Conclusion

This study showed that receiving both conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery has a lower recurrence rate than conjunctival autograft transplantation only.

Therer is no major complications such as necrotizing scleritis, sclera ulcer, corneal perforation were noted after surgery.