Abstract:AIM: To observe the curative effects of pterygium conjunctiva reverse transplantation combined with amniotic membrane transplantation for treatment of recurrent pterygium.
METHODS: A retrospective case series study. Twenty-six eyes of 26 cases with recurrent pterygium in our hospital from January 2009 to January 2012 underwent pterygium excision combined with autologous limbal stem cell transplantation and recurred more than one year. In this study, when the pterygium tissue was excised, the conjunctiva was cut and preserved after it was fully free, then the preserved conjunctiva was put reversely to cover the amniotic membrane and sutured after amniotic membrane covering the bare conjunctiva. The conjunctival graft healing condition, amniotic membrane dissolution, corneal wound repair, corneal neovascularization and pterygium recurrence rate 1 week, 2 weeks, 1 month, and 3 months after operation were observed. The follow-up period was 12 months.
RESULTS: Conjunctival graft healing time was 6.03±2.76 days, amniotic membrane dissolved absorption time was 14.26±3.64 days, corneal wound repair time was 5.42±1.58 days. In postoperative 3 months, new conjunctiva in bare sclera surface and conjunctival graft healed well, no obvious pterygium postoperative complications. In postoperative 1 year, 2 cases with recurrent pterygium recurred, pterygium recurrence rate was 8%, cure rate was 92%.
CONCLUSION: For recurrent pterygium, due to the traditional autologous corneal limbal stem cell transplantation has injured partial limbal and conjunctival scar, the postoperative pterygium recurrence rate is very high after single conjunctival transplantation or amniotic membrane transplantation. This method takes the pterygium conjunctiva reverse transplantation and avoids large area wound of ocular surface, obtains surgery materials easily and controls the postoperative recurrence of pterygium well, which is a good choice for treating recurrent pterygium.