Volume 25, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2019)                   Avicenna J Clin Med 2019, 25(4): 215-221 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Eslami F, Alizadeh M, Seifrabiei M A, Mohebi Emam N. Comparison of Amniotic Membrane Transplantation and Conjunctival Autograft Transplantation for the Treatment of Pterygium. Avicenna J Clin Med. 2019; 25 (4) :215-221
URL: http://sjh.umsha.ac.ir/article-1-1828-en.html
1- Assistant Professor, Department of Ophthalmology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2- Assistant Professor, Department of Ophthalmology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran , mahaliz@yahoo.com
3- Associate Professor, Department of Social Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4- General Practitioner, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract:   (2709 Views)
Background and Objective: Pterygium is a fibrovascular and wedge-shaped lesion that extends from bulbar conjunctiva to the cornea. Pathogenesis of pterygium depends on several factors and sunlight exposure is an important risk factor for this syndrome. Surgery is regarded as the key to successful treatment of pterygium. With this background in mind, the aim of this study was to determine the effect of amniotic membrane transplantation (AMT) for the treatment of pterygium. Moreover, this technique was compared clinically with conjunctival autograft transplantation (CAT).
Materials and Methods: In this randomized clinical trial, 70 patients either referred to the ophthalmologic clinic of Farshchian Hospital in Hamadan, Iran, or diagnosed by an ophthalmologist with primary or recurrent pterygium were enrolled in this study. The patients were randomly divided into two groups, (n=35). One group underwent pterygium surgery using AMT and the other one was subjected to CAT. Furthermore, the inflammation and recurrence rates after surgery were compared in both groups. Data were analyzed in SPSS software (Version16) through the Chi-square and the independent sample t-tests.
Results: According to the results, the mean ages of patients in the AMT and CAT groups were 47.34±14.85 and 48.26±15.26 years, respectively (P=0.778). Moreover, inflammation was observed in 28.6% and 8.6% of patients in the AMT and CAT groups, respectively. The recurrence rates were 22.9% and 11.4% in the AMT group and CAT group, respectively (P=0.205)
Conclusion: The AMT had a higher recurrence rate and postoperative inflammation, compared to the CAT. Although this difference was not statistically significant, the CAT is widely used as a treatment for patients with pterygium.
Full-Text [PDF 316 kb]   (692 Downloads)    
Type of Study: Original | Subject: Ophthalmology (all specialties)

References
1. Kheirkhah A, Casas V, Sheha H, Raju VK, Tseng SC. Role of conjunctival inflammation in surgical outcome after amniotic membrane transplantation with or without fibrin glue for pterygium. Cornea. 2008;27(1):56-63. PMID: 18245968 DOI: 10.1097/ICO.0b013e31815873da
2. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparsion of conjenctivalautograft, amniotic membrane grafts, and primary closure for pterygumexcsision. Ophtalmology. 1997;104(6):974-85. PMID: 9186439
3. Luthra R, Nemesure BB, Wu SY, Xie SH, Leske MC. Frequency and risk factors for pterygium in the Barbados Eye Study. Arch Ophthalmol. 2001;119(12):1827-32. PMID: 11735795
4. Cajucom-Uy H, Tong L, Wong TY, Tay WT, Saw SM. The prevalence of and risk factors for pterygium in an urban Malay population: the Singapore Malay Eye Study (SiMES). Br J Ophthalmol. 2010;94(8):977-81. PMID: 19965830 DOI: 10.1136/bjo.2008.150847
5. Hirst LW. The treatment of pterygium. Surv Ophthalmol. 2003;48(2):145-80. PMID: 12686302
6. Marchovich AL, Bahar I, Srinivasan S, Slomovich AR. Surgical management of pterygium. Int Ophthalmol Clin. 2010;50(3):47-61. PMID: 20611017 DOI: 10.1097/IIO. 0b013e3181e218f7
7. Bradley JC, Yang W, Bradley RH, Reid TW, Schwab IR. The science of pterygia. Br J Ophthalmol. 2010;94(7):815-20. PMID: 19515643 DOI: 10.1136/bjo.2008.151852
8. Tan DT, Chee SP , Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctiva autographing with bare sclera excision. Arch Ophthalmol. 1997;115(10):1235-40. PMID: 9338666
9. Solomon A, Pires RT, Tseng SC. Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia. Ophthalmology. 2001;108(3):449-60. PMID: 11237898
10. Bekibele CO, Baiyeroju AM, Olusanya BA, Ashaya AO, Oluleye TS. Pterygium treatment using 5-UF as adjust treatment compared to conjuctiva autograft. Eye. 2008;22(1):31-4.
11. Koranyi G, Artzen D, Seregard S, Kopp ED. Intraoperative mitomycin C versus autologous conjunctival autograft in surgery of primary pterygium whit four-year follow up. Acta Ophthalmol. 2012;90(3):266-70. DOI: 10.1111/j.1755-3768.2010.01936.x
12. Jampel HD. Effect of brief exposure of mitomycin C on viability and proliferation of cultured human Tenon`s capsule fibroblasts. Ophthalmology. 1992;99(9):1471-6. PMID: 1407982
13. Crowston JG, Akbar AN, Constable PH, Occleston NL, Daniels JT, Khaw PT. Antimetabolite-induced apoptosis in Tenon`s capsule fibroblasts. Invest Ophthalmol Vis Sci. 1998;39(2):449-54. PMID: 9478007
14. Ti SE, Tseng SC. Management of primary and recurrent pterygium usingamniotic membrane transplantation. Curr Opin Ophtalmol. 2002;110(1):93-100. PMID: 12165701
15. Solomon A, Espana EM, Tseng SC. Amniotic membrane transplantation for reconstruction of the conjunctival fornics. Ophtalmology. 2003;110(1):93-100. PMID: 12511352
16. Sangwan VS, Ramamurthy B, Datar SG. Evaluation of outcome of amniotic membrane transplantation with conjunctival limbal autograft for pterygium. Asian J Ophthalmol. 2006;8(1):20-3.
17. Luanratanakorn P, Ratanapakorn T, Suwan-apichon O, Chuck RS. Randomised controlled study of conjunctival autograft versus amniotic membrane graft in pterygium excision. Br J Ophtalmology. 2006;90(12):1476-80. PMID: 16837545 DOI: 10.1136/bjo.2006.095018
18. Kheirkhah A, Nazari R, Nikdel M, Ghassemi H, Hashemi H, Behrouz MJ. Postoperative conjunctival inflammation after pterygium surgery with amniotic membrane transplantation versus conjunctival autograft. Am J Ophthalmol. 2011;152(5):733-8. DOI: 10.1016/j.ajo.2011.04.013
19. Ma DH, See L, 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. PMID: 10966947
20. Guler M, Sobaci G, Ilker S, Öztürk F, Mutlu FM, Yildirim E. Limbal-conjunctivalautograft transplantation in cases with recurrent pterygium. Acta Ophthalmol. 1994;72(6):721-6. DOI: 10.1111/j.1755-3768.1994.tb04688.x
21. Cameron ME. Histology of pterygium: an electron microscopicstudy. Br J Ophthalmol. 1983;67(9):604-8. PMID: 6882718
22. Chen JK, Tsai RJ, Lin SS. Fibroblasts isolated fromhuman pterygia exhibit transformed cell characteristics. In Vitro Cell Dev Biol Anim. 1994;30A(4):243-8. PMID: 7520809
23. Lee SB, Li DQ, Gunja-Smith Z, Liu YQ, Tan DT, Tseng SC. Increased expressionand activity of MMP-1 and MMP-3 by cultured pterygiumhead fibroblasts. Invest Ophthalmol Vis Sci. 1999;40(4):S334.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2022 CC BY-NC 4.0 | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb