Pterygium removal surgery eliminates the abnormal tissue from the cornea and sclera white of the eye. Pterygium is considered a chronic lesion of the bulbar conjunctival tissue characterized by epithelial hyperplasia and elastotic degeneration. Comparison of wide conjunctival flap and conjunctival. Your browser does not currently recognize any of the video formats available. Article information, pdf download for rotatory conjunctival flap for pterygium removal.
A comparison between surgical techniques for securing conjunctival autografting in primary pterygium surgery the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Postoperative conjunctival inflammation after pterygium surgery with amniotic membrane transplantation versus conjunctival autograft. Pterygium removal with conjunctival autograft and mitomycin c. The third technique shown in the video is studied in this article. Pdf pterygium excision with conjunctival autografting. Pterygium excision with conjunctival autograft and. Postoperative conjunctival inflammation after pterygium. Longterm followu of pterygium surgery using a conjunctival autograft and tissucol published online ahead of print sept. The technique of conjunctival autografting has been shown to be an effective method of preventing recurrences after excision of advanced and recurrent pterygium,5, 6 and we recently concluded a prospective, randomized, controlled pterygium surgery trial comparing this with bare sclera excision. A comparison between surgical techniques for securing. Low recurrence rate of anchored conjunctival rotation flap technique. This surgery is done under peribulbar anaesthesia with good orbicularis oculi akinesia.
Conjunctival autograft for pterygium johns hopkins. During the past decade, the debate over the best approach to pterygium surgery has centered on whether surgeons should use sutures or fibrin glue to affix the conjunctival graft. Please return to our office for your postoperative visit as directed. Pterygium excision and conjunctival autograft is a surgical procedure which involves. These days special interest has been generated ever since someone found out that a conjunctival autograft can stick to the bare sclera bed without the aid of any sutures. Pterygium excision w conj autograft, no sutures, no glue. A comparison of anchored conjunctival rotation flap and. Narrowstrip conjunctival autograft for treatment of pterygium. Conjunctival autograft transplantation may prevent. There is a 10% possibility of the pterygium recurring, if it is highly developed, and can.
Mar 29, 2016 this video describes the basic surgical principles of pterygium surgery. Surgical removal is the mainstay treatment with autologous blood used as tissue adhesive to prevent recurrences and scarring. Surgical removal is the treatment of choice, but recurrence of pterygium is a. Pterygium surgery with conjunctival autograft remains the gold. A video of pterygium surgery with conjunctival autograft with no sutures and no glue was done about a month back. Dec 05, 2015 pterygium excision with free conjunctival limbal autograft 1. Postoperative instructions for pterygium removal conjunctival removal osr special instructions. Pterygium surgery using a conjunctival autograft is associated with recurrence in 5% of cases. Conjunctival autograft adhesion with fibrin glue has gained rapid popularity in pterygium excision surgery and is now the technique of choice in many centers worldwide. Pterygium excision with conjunctival autograft youtube.
A video of this surgery is shown in online resource. Pterygium surgery using the principle of contact inhibition. Current surgical methods to prevent pterygium recurrence include conjunctival autograft with limbal to limbal. The recurrence rate following surgery is low, ranging from 5% to 10%. Pterygium surgery with conjunctival autograft dnatube. Iosr journal of dental and medical sciences iosrjdms eissn. Cutandplace technique of pterygium excision with autograft without. Surgeon details pterygium surgery technique with autolimbal.
Patients undergoing pterygium surgery with conjunctival autografting were randomized into groups receiving 100 vicryl sutures, evicel fibrin glue, or tisseel fibrin glue. Surgeon details pterygium surgery technique with auto. Accepted 24 november, 2016 this is a retrospective study to determine the risk factors for sclera necrosis after excision of pterygium and conjunctival autograft. The additional use of mitomycin c is of unclear effect.
Extended pterygium removal with extended conjunctival autograft. Impact of conjunctival autograft on pterygium treatment. The main primary outcome concerns are recurrence of pterygium, cosmesis, other complications like dislocation of conjunctival graft or ham graft. One group was a complete dissection and excision to the posterior margin and the other group was an excision limited to visible pterygium overlying conjunctiva. Preventing conjunctival autograft inversion in pterygium. To describe a simple method of conjunctival autograft. Pterygium surgery mountain view peninsula laser eye. Patch will be removed at your postoperative appointment. Extended pterygium removal with extended conjunctival autograft the premise on which this procedure is designed is firstly to reduce the recurrence rate. Conjunctival autograft for pterygium johns hopkins university. Pterygium surgery with autoconjunctival graft video. Scleral necrosis after pterygium excision and conjunctival autograft ali a ghali, md assist prof of ophthalmology, alazhar university damitta. Pterygium excision procedure manchester eye surgery. Large pterygium, encroaching the pupillary area, was operated.
Pterygium is a frequent conjunctival abnormality in outdoor workers. Nostitch pterygiumautograft surgery allows most patients to return to work within one or two days of surgery. Using a scissors to cut the pterygium from the adjacent conjunctiva using a scissors or blade to excise the pterygium from the corneal surface. Conjunctival autograft transplantation for advanced and recurrent. Refer to your surgery schedule for dates and times. Autologous blood as tissue adhesive for conjunctival. Pterygium excision with conjunctival autograft eyetube. John hofbauer, md, and nicole fram, md, present a case of pterygium excision in a 38year old hispanic male using conjunctival autograft, fibrin glue, mitomycin 0. Cornea, ocular surface, conjunctival, and refractive. Comparative study of pterygium excision with conjunctival. A research study on 85 patients with pterygium conducted at harvard eye associates has shown that patients undergoing nostitch surgery had significantly less pain after surgery than those having traditional surgery. Since kenyon et al 14 first described their conjunctival autograft procedure for the management of pterygium, this surgical technique has been considered the most effective and safest procedure for reducing recurrence while avoiding the risk of potentially serious complications.
Graft was fixed with 2 polyglyconate sutures on limbus. Analysis of recurrence patterns following pterygium surgery. Sutureless and gluefree conjunctival autograft in pterygium. Technique of pterygium excision with conjunctival limbal autografting is described and the safety and efficacy of the procedure in india is analysed. Cauterisation versus fibrin glue for conjunctival autografting in.
A pterygium is a wedge shaped tissue that grows over the surface of the eye it may occasionally extend over the cornea enough to affect clarity of vision it varies in colour from pale pink to crimson red. This video demonstrates the importance of careful dissection to the root of the pterygium rather than simply excising the pterygium flush to the plica. In the group who underwent surgery for recurrent pterygium, all 23 patients 20 with nasal and 3 with temporal pterygia had conjunctival autografts. The surface conjunctiva on the pterygium body was not removed. The features of this surgery that may reduce the recurrence are 1 extensive physical excision of tenons fascia superior, inferior, and nasal to the pterygium and 2 intensive use of. Video 2this video demonstrates three techniques for pterygium surgery. The technique demonstrated in this video makes use of tisseel fibrin glue to anchor the graft in the bed.
Pterygium surgery with conjunctival autograft youtube. Pterygium excision with conjunctival autograft on vimeo join. Preventing conjunctival autograft inversion in pterygium surgery. Pterygium surgery with conjunctival autograft risks like with all surgery, complications can occur, such as infection 0. Optimal size of pterygium excision for limbal conjunctival autograft. Pterygium surgery with conjunctival autograft, what is this. Pterygium is defined as a triangular fibrovascular growth of connective tissue covered with conjunctival epithelium which extends over the corneal surface from the corneoscleral margin. New approach emerges for pterygium surgery american academy. The video shows the method of pterygium removal by conjunctival autografting. Conjunctival autograft transplantation may prevent pterygium. A surgical video demonstrating the technique of pterygium removal with conjunctival autograft and tiseel glue.
We describe a simple method of achieving conjunctival autograft adherence during pterygium surgery avoiding potential complications associated with the use of fibrin. A comparison between surgical techniques for securing conjunctival autografting in primary pterygium surgery the safety and scientific validity of this study is the. This video shows pterygium excision and conjunctival autograft. Unfortunately, this led to a high rate of pterygium regrowth. More research is needed to determine which type of surgery resulted in better vision or quality of life. Conjunctival autograft transplantation for advanced and recurrent pterygium.
Scleral necrosis after pterygium excision and conjunctival. Forty two consecutive patients had undergone pterygium excision with either conjunctival autografting or conjunctival zplasty randomly. Matt ward, md pterygium surgery with conjunctival autograft remains the gold standard for reducing recurrence after its initial description in 1985 kenyon kr, wagoner md hettinger me. Pterygium excision combined with a tissue graft has a lower risk of recurrence. Pterygium excision and conjunctival autograft video.
The sandwich technique simplifies conjunctival graft fixation during pterygium surgery with conjunctival autograft by allowing more time to properly position the autograft before fibrin clot. Pterygium surgery with conjunctival autograft, what is. Pterygium excision with free conjunctival limbal autograft. Optimal size of pterygium excision for limbal conjunctival. Nostitch pterygium autograft surgery allows most patients to return to work within one or two days of surgery. The patient had a progressive pterygium in the affected eye approaching in the central visual axis.
In this photo, the pterygium has an associated conjunctival cyst, which is even more likely to interfere with lubrication of the ocular surface surgery involves careful removal of the pterygium from the cornea and adjacent nasal conjunctiva. A picture of the patient after 1 month is also incorporated in the video. Results showed that the effect of wide conjunctival flap techniques on primary pterygium surgery was found close to the conjunctival autograft techniques. Pterygium surgery with conjunctival autograft with no sutures and no glue steps. Mean followup time in the autograft group and the zplasty group was 18 and 17 months, respectively. Extended pterygium removal with extended conjunctival. Graft was fixed using own blood clot as tissue adhesive which oozed in the bare sclera after pterygium. Cohen, md, phd, presents a technique for conjunctival autograft for pterygium. Both approaches have their pros and cons in terms of such factors as surgical time, postoperative complications, cosmesis and recurrence.
Analysis of recurrence patterns following pterygium. The older, standard surgical technique left a bare hole in the conjunctiva the surface of the eye where the pterygium was removed. Using conjunctival autograft and prophylactic subconjunctival placement of amniotic membrane. In conjunctival autograft surgery, conjunctival tissue from another part of the persons eye along with limbal tissue is resected in one piece and used to cover the area from which the pterygium was excised. Oct 02, 2012 pterygium surgery with conjunctival autograft remains the gold standard for reducing recurrence after its initial description in 1985 kenyon, k. Wed like to understand how you use our websites in order to improve them. Pterygium removal with conjunctival autograft youtube.
Pterygium excision with conjunctival autograft on vimeo. It has enabled a suturefree technique, reducing surgical time and postoperative pain. Pterygium surgery with conjunctival autograft remains the gold standard for reducing recurrence. Conjunctival autograft excision of pterygium video. The tumorlike characteristics of pterygium are expressed when reproliferation occurs after excisional. After surgery, pyogenic granuloma developed in 3 eyes 15. Pterygium evulsion surgery with no stitch no glue autograft. Although the best technique for a successful outcome after pterygium excision is yet to be determined, conjunctival autografting after pterygium excision has superior success rates compared with simple bare sclera excision of the pterygium. In 1985, kenyon et al 1 proposed that a conjunctival autograft of the bare sclera could be used in treatment of recurrent and advanced pterygium. Shannon wong, md presents a edited version of the steps for pterygium removal, creation and fixation of a conjunctival autograft with. Pterygium surgery with conjunctival autograft remains the gold standard for reducing recurrence after its initial description in 1985 kenyon, k. Lidocaine with epinephrine is injected to balloon the pterygium and conjunctiva to make dissection easier. The spectrum of procedures includes pterygium excision wide excision or mini excision, usually combined with various grafting techniques, use of conjunctival autograft or amniotic membrane, and. In the present study, we aimed to compare the wide conjunctival flap and the conjunctival autografting techniques in pterygium surgery according to time of operation, safety, and effectiveness.