Surgical result of pterygium extended removal followed by fibrin glue-assisted amniotic membrane transplantation

J Formos Med Assoc. 2017 Jan;116(1):10-17. doi: 10.1016/j.jfma.2015.10.013. Epub 2016 Feb 8.

Abstract

Background/purpose: To report the recurrence rate and cosmetic results of conjunctival wound edge and caruncle, and complications after pterygium extended removal followed by fibrin glue-assisted amniotic membrane transplantation.

Methods: A prospective interventional cohort study enrolled 57 (58 eyes) patients undergoing pterygium extended removal followed by fibrin glue-assisted amniotic membrane transplantation. All patients received postoperative follow-up for at least 12 months. Recurrence rate was graded from 1 to 4, and cosmetic results of conjunctival edge and caruncle were graded from 1 to 5.

Results: The cohort included 48 eyes with nasal pterygium, 5 eyes with temporal pterygium, and 5 eyes with double pterygium. There were 81.0% (n=47), 0% (n=0), 12% (n=7), and 7% (n=4) of eyes with Grades 1-4 recurrence, respectively. The cosmetic results of conjunctival wound edge and caruncle in cases with nasal pterygium showed 59.3% (n=32), 14.8% (n=8), 9.3% (n=5), 16.6% (n=9), and 0% (n=0) of eyes with Grades 1-5 morphology, respectively. Overall, 5.1% (n=3), 3.4% (n=2), 3.4% (n=2), 3.4% (n=2), 1.7% (n=1), 6.9% (n=4), and 1.7% (n=1) of patients suffered from postoperative pyogenic granuloma, transient diplopia, permanent motility restriction, steroid glaucoma, fat prolapse, subamniotic membrane hemorrhage, and early detachment of amniotic membrane, respectively.

Conclusion: Pterygium extended removal followed by fibrin glue-assisted amniotic membrane transplantation results in low recurrence, satisfactory cosmetic results and a low incidence of additional complications.

Keywords: amniotic membrane transplantation; caruncle; fibrin glue; pterygium; recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amnion / transplantation*
  • Female
  • Fibrin Tissue Adhesive / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Pterygium / surgery*
  • Recurrence
  • Surgery, Plastic*
  • Taiwan
  • Treatment Outcome

Substances

  • Fibrin Tissue Adhesive