Pterygium Recurrence in Amniotic Membrane Graft and Mitomycin C Me-thods

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Ophthalmology and Ocular Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Ophthalmology and Ocular Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Due to recent application of amniotic membrane graft in the eye surgeries, this study was done to investigate the efficacy and safety of amniotic membrane graft as an adjunctive therapy after removing primary pterygium and to compare its clinical outcomes with topical mitomycin C.Methods: In this clinical trail, 34 eyes of 34 patients with primary pterygium were treated with excision followed by amniotic membrane graft. The result was compared with 34 eyes of 34 patients receiving topical mitomycin C. The patients were followed for 6 months for recurrence.Finding: There were two recurrences (5.9%) in the amniotic membrane graft group and eight recurrences (23.6%) in the topical mitomycin C group. There was significant difference in recurrence rate among two groups (P = 0.045). No major complications occurred in the amniotic membrane graft group. Two cases of pyogenic granoloma and thinning sclera occurred in the topical mitomycin C group.Conclusion: This study showed that amniotic membrane graft was an effective method in treatment of primary pterygium and can be considered as a preferred grafting procedure for primary pterygium.

Keywords

References

  1. Saw SM, Tan D. Pterygium: prevalence, demography and risk factors. Ophthalmic Epidemiol 1999; 6(3): 219-28.
  2. Dua HS, Azuara-Blanco A. Amniotic membrane transplantation. Br J Ophthalmol 1999; 83(6): 748-52.
  3. Cano-Parra J, Diaz-Llopis M, Maldonado MJ, Vila E, Menezo JL. Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium. Br J Ophthalmol 1995; 79(5): 439-41.
  4. Cameron ME. Histology of pterygium: an electron microscopic study. Br J Ophthalmol 1983; 67(9): 604-8.
  5. Guler M, Sobaci G, Ilker S, Ozturk F, Mutlu FM, Yildirim E. Limbal-conjunctival autograft transplantation in cases with recurrent pterygium. Acta Ophthalmol (Copenh) 1994; 72(6): 721-6.
  6. Lee SH, Tseng SC. Amniotic membrane transplantation for persistent epithelial defects with ulceration. Am J Ophthalmol 1997; 123(3): 303-12.
  7. Tseng SC, Prabhasawat P, Lee SH. Amniotic membrane transplantation for conjunctival surface reconstruction. Am J Ophthalmol 1997; 124(6): 765-74.
  8. Azuara-Blanco A, Pillai CT, Dua HS. Amniotic membrane transplantation for ocular surface reconstruction. Br J Ophthalmol 1999; 83(4): 399-402.
  9. Shimazaki J, Yang HY, Tsubota K. Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns. Ophthalmology 1997; 104(12): 2068-76.
  10. Tsubota K, Satake Y, Ohyama M, Toda I, Takano Y, Ono M, et al. Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Am J Ophthalmol 1996; 122(1): 38-52.
  11. Choi YS, Kim JY, Wee WR, Lee JH. Effect of the application of human amniotic membrane on rabbit corneal wound healing after excimer laser photorefractive keratectomy. Cornea 1998; 17(4): 389-95.
  12. Fujishima H, Shimazaki J, Shinozaki N, Tsubota K. Trabeculectomy with the use of amniotic membrane for uncontrollable glaucoma. Ophthalmic Surg Lasers 1998; 29(5): 428-31.
  13. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997; 104(6): 974-85.
  14. Shimazaki J, Shinozaki N, Tsubota K. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol 1998; 82(3): 235-40.
  15. Fukuda K, Chikama T, Nakamura M, Nishida T. Differential distribution of subchains of the basement membrane components type IV collagen and laminin among the amniotic membrane, cornea, and conjunctiva. Cornea 1999; 18(1):73-9.
  16. Sonnenberg A, Calafat J, Janssen H, Daams H, van der Raaij-Helmer LM, Falcioni R, et al. Integrin alpha 6/beta 4 complex is located in hemidesmosomes, suggesting a major role in epidermal cell-basement membrane adhesion. J Cell Biol 1991; 113(4): 907-17.
  17. Ma DH, See LC, Liau SB, Tsai RJ. Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000; 84(9): 973-8.
  18. Kim JC, Tseng SC. Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea 1995; 14(5): 473-84.
  19. Hao Y, Ma DH, Hwang DG, Kim WS, Zhang F. Identification of antiangiogenic and antiinflammatory proteins in human amniotic membrane. Cornea 2000; 19(3): 348-52.
  20. Mahar PS, Nwokora GE. Role of mitomycin C in pterygium surgery. Br J Ophthalmol 1993 ;77(7): 433-5.
  21. Panda A, Das GK, Tuli SW, Kumar A. Randomized trial of intraoperative mitomycin C in surgery for pterygium. Am J Ophthalmol 1998; 125(1): 59-63.
  22. Ma DH, See LC, Hwang YS, Wang SF. Comparison of amniotic membrane graft alone or combined with intraoperative mitomycin C to prevent recurrence after excision of recurrent pterygia. Cornea 2005; 24(2): 141-50.
  23. Tananuvat N, Martin T. The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft. Cornea 2004; 23(5): 458-63.
  24. Massaoutis P, Khemka S, Ayliffe W. Clinical outcome study of a modified surgical technique for pterygium excision. Can J Ophthalmol 2006; 41(6): 704-8.
Journal of Isfahan Medical School
Volume 28, Issue 122 - Serial Number 122
November and December 2011
Pages 1808-1813

Files

History

  • Receive Date: 03 April 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics