A Comparative Study of Recurrence Rate in Bilateral Pterygium Surgery: Conjunctival Autograft Transplantation Versus Bare Scleral Techinque

PURPOSE: When the patients with both recurrent and primary pterygia, We performed conjunctival autograft transplantation for recurrent pterygium and bare sclera technique for primary pteygium. We then compared the recurrence of each case in order to find out the usefulness of each surgery and effective mothod of surgery. METHODS: We performed follow-up on 26 eyes of 13 patients for 14 months (mean); 8 patients (16 eyes) were female, and 5 patients (10 eyes) male. The mean age of the patients was 49.5 years ranging from 37 to 63. In the operation, all patients received with 0.02% Mitomycin C for 1 minute. RESULTS: Pterygium recurred in 3 of 13 eyes which underwent bare sclera technigue, and did not recur in 13 eyes undergoing conjunctival autograft transplantation, but there was no significant difference because of a small number of study cases (P=0.07). We found postoperative complications such as corneal fila-ment and conjunctival granuloma in the case of bare sclera technique; but none in conjunctival autograft transplantation. CONCLUSIONS: We recommend a conjunctival autograft transplantation with application of low concen-tration of Mitomycin C as a safe and effective method for recurrent pterygium or pterygium with high recurrence rate.

Pterygium Surgery Using Dermabrader

The aim of this study was to evaluate safety and effectiveness of dermabrader to smooth the wound bed in pterygium surgery. A total dof 69 eyes of 62 patients were divided into two groups according to surgical method. 33 eyes of 29 patients who underwent pterygium surgery with bare-sclera technique and smoothing of the wound bed using dermabrader were included in group 1 and 36 eyes of 33 patients with bare aclera technique only were included in group 2. Postoperatively, the eyes were medically treated with topical mitomycin C(0.02%) two times per day for 5 days in both groups. The mean follow up visit was 12.1+/-2.89 months(range: 9-15months). Recurrence developed in 3(9.1%) of 33 eyes in group 1, while in 12(33.3%) of 36 eyes in group 2. This difference was statistically significant(p<0.05). This result suggests that the excision of pterygium using the bare-sclera technique, smoothing of the wound bed using dermabrader and low dose topical mitomycin C(0.02%) eye drops is a safe and effective method with a low recurrence rate.

Re-epithelialization of the Conjunctiva After Conjunctival Excision in the Rabbits

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.

Re-epithelialization of the Conjunctiva After Conjunctival Excision in the Rabbits

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.