This article is more than 5 years old. Information may no longer be current.
Inflammation common after pterygium surgery with amniotic membrane transplantation
Am J Ophthalmol. 2011;152(5):733-738.
Click Here to Manage Email Alerts
Conjunctival inflammation was more common after pterygium surgery with amniotic membrane transplantation as opposed to conjunctival autograft, a study found.
"However, with control of such inflammation and intraoperative application of mitomycin C, similar final outcomes were achieved with both techniques," the study authors said.
The prospective, randomized study included 39 eyes of 39 patients that underwent primary pterygium excision and subsequent removal of subconjunctival fibrovascular tissue and intraoperative application of 0.02% mitomycin C.
Nineteen eyes underwent amniotic membrane transplantation and 20 eyes received conjunctival autografts.
Study results showed that at 1 month postop, 16 eyes (84.2%) in the amniotic membrane transplantation group and three eyes (15%) in the conjunctival autograft group showed different grades of host conjunctival inflammation. The between-group difference was statistically significant (P = .02).
Twelve eyes (63.1%) in the amniotic membrane transplantation group and two eyes (10%) in the conjunctival autograft group had moderate or severe inflammation and underwent subconjunctival triamcinolone injection. The between-group difference was statistically significant (P < .001).
Pterygium recurred in two eyes (10.5%) in the amniotic membrane transplantation group and two eyes (10%) in the conjunctival autograft group. The between-group difference was statistically insignificant.
Pyogenic granuloma was identified in three eyes (15.8%) in the amniotic membrane transplantation group and one eye (5%) in the conjunctival autograft group; the between-group variation was insignificant, the authors said.
This article compares the postoperative conjunctival inflammation after pterygium excision with conjunctival autograft and amniotic membrane transplantation (AMT). The 1-year-long follow-up taken by the authors is appreciated. From the results, host conjunctival inflammation is noted to be higher in the AMT group. But there is no significant difference in the recurrence.
The article clearly shows that conjunctival inflammation of grade 3 and 4 can be treated successfully with subconjunctival steroids.
There seems to be a higher incidence of pyogenic granuloma (15.8%) in the AMT group, and all granuloma are observed to have developed in the caruncular border of the graft. However, the etiology behind the granuloma and its predilection on caruncular side remains unclear. The role of morphology of pterygium, surgical techniques, prophylactic anti-inflammatory agents or antivascular endothelial growth factors in conjunctival inflammation needs to be studied in the future.
– Amar Agarwal, MS, FRCS, FRCOphth
OSN
Asia-Pacific Editorial Board Member
Disclosure: No products or companies
are mentioned that would require financial disclosure.