Efficacy of modified pterygium resection combined with conjunctival autograft transplantation in the treatment of pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the efficacy of modified pterygium resection combined with conjunctival autograft transplantation(CAT)in the treatment of pterygium.METHODS: A total of 140 patients(154 eyes)with pterygium treated in the ophthalmology department of our hospital from January 2018 to January 2021 were selected and grouped according to random number table method. In the observation group, 70 cases(76 eyes)were treated with modified pterygium excision combined with CAT, and improved iris restorer was used during the operation. In the control group, 70 patients(78 eyes)were treated with conventional pterygium excision combined with CAT, during which traditional iris restorer was used. Follow up for 1a, the postoperative vision, subjective symptoms, conjunctival signs(conjunctival congestion and chemosis), corneal epithelial healing, postoperative complications and recurrence rate were compared between the two groups.RESULTS: Compared with pre-operation, vision of the two groups decreased significantly on 1, 3 and 5d after operation(P<0.05), while there was no statistically significant difference between the groups(P>0.05). Compared with 1d after operation, the scores on subjective symptoms, conjunctival hyperemia and edema in the two groups decreased significantly on 3, 5 and 14d after operation(P<0.05), and those scores of the observation group on 3, 5 and 14d after operation were significantly lower than those of control group(P<0.05).The corneal fluorescein staining(FL)scores of the observation group on 3, 5 and 14d after operation were significantly lower than those of the control group(P<0.05). The proportion of repair time of corneal epithelial defect ≤5d in the observation group was significantly higher than that in the control group(P<0.05). The incidence rates of conjunctival granuloma, symblepharon, and the recurrence rate in the observation group were significantly lower than those in the control group(P<0.05).CONCLUSION: Modified pterygium resection combined with CAT is effective in the treatment of pterygium, which can alleviate postoperative irritative symptoms, conjunctival congestion and edema, and it is more conducive to postoperative corneal epithelial reconstruction, reduction of postoperative complications and recurrence rate.

Perioperative nursing care of 25 patients underwent total parathyroidectomy with forearm autograft / 中华护理杂志

To summarize key points of nursing care of 25 patients with secondary hyperparathyroidism underwent parathyroid autotransplantation with forearm (tPTX+AT).The integrated mode was adopted during the perioperative period,focusing on the following key points:perioperative management of environment,nursing of vascular access,intro-operative management of sample,nursing management during anesthesia and recovery,management of drawing blood,treatment and nursing care of postoperative hypocalcemia,prevention and nursing care of infection and hemorrhage,wound care in the forearm and monitoring of graft.Compared with the preoperative period,levels of intact parathyroid hormone(iPTH),calcium and phosphorus were significantly decreased during the postoperative period (P＜0.01);symptoms were significantly improved after surgery included bone and joint pain,muscular weakness,and insomnia.

Effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular burns / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular surface repair time, repair rate and complications in patients with ocular burns. <p>METHODS: The clinical data of each 61 cases(61 eyes)of patients with ocular burns who were treated by limbal stem cell autograft transplantation(control group)or amniotic membrane transplantation combined with limbal stem cell autograft transplantation(observation group)were retrospectively analyzed. The postoperative ocular surface repair rate, repair time, and visual acuity and complications(symblepharon, corneal neovascularization, and keratohelcosis)at 12wk after operation were recorded in the two groups, and the levels of cytokines \〖vascular endothelial growth factor(VEGF), transforming growth factor-β1(TGF-β1), insulin-like growth factor-1(IGF-1)\〗 were compared between the two groups before operation and at 2wk after operation. <p>RESULTS: The postoperative ocular surface repair rate in observation group was higher than that in control group(<i>P</i><0.05)while the repair time was less than that in control group(<i>P</i><0.05). At 12wk after operation, the visual acuity in observation group was significantly better than that in control group(<i>P</i><0.05), and the total incidence rate of postoperative complications in observation group was significantly lower than that in control group(<i>P</i><0.05). At 2wk after operation, the levels of serum VEGF, TGF-β1 and IGF-1 in the two groups were significantly higher than those before operation(<i>P</i><0.05), and the levels in control group were higher than those in observation group(<i>P</i><0.05). <p>CONCLUSION: Amniotic membrane transplantation combined with limbal stem cell autograft transplantation has significant treatment effects on patients with ocular burns, and it can promote ocular surface repair, improve postoperative visual acuity, and can also regulate corneal neovascularization, and it also has positive significance in reducing the risk of postoperative complications.

Limbal-conjunctival autograft transplantation for the management of primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the efficiency of limbal conjunctival autografting technique in patients with primary pterygium.·METHODS: Fifteen eyes of 15 patients with primary pterygium underwent surgery for the removal of pterygium with limbal conjunctival autograft. After the pterygium excision, the limbal portion of the graft was oriented and sutured to the limbus at the recipient bed with the epithelial surface upside. Recurrence was defined as fibrovascular tissue of more than 1 mm over the cornea in the area of previous pterygium excision.·RESULTS: With mean follow-up period of 8 months, neither recurrences nor serious complications were recorded among our patients.·CONCLUSION; Simple excision followed by limbal-conjunctival autograft transplantation is a safe and very effective way of treating primary pterygium.

Sclerocorneal limbal stem cell autograft transplantation in dogs

The effects of sclerocorneal limbal stem cell autograft transplantation in dogs with corneal wounds were studied. Eighteen dogs were divided in two groups (GI and GII). The animals of GI (n=12) underwent limbal transplantation 30 days after the destruction of limbal stem cells. The dogs of GII (n=6) only underwent destruction of stem cells (control group). Light microscopy examination of the right eye was performed on days 3, 7, 14, 30, 60, and 120 after limbal transplantation (GI), and on days 33, 37, 44, 60, 90, and 150 after limbal destruction (GII). Results showed a complete destruction of limbal stem cells with loss of corneal transparency. Limbal transplantation prevented conjunctivalization in grafted area. Corneal vascularization and a 360º corneal conjunctivalization were noted in the control dogs (GII). Corneal transparency was restored from day 60th after surgery. Histological examination did not distinguish the transition between the graft and the normal corneal epithelium at anytime. Goblet cells were found in control animals (GII) on 33, 37, 60, and 150 days, whereas a single grafted dog (GI) presented a few goblet cells on day 60th post-transplantation. Limbal autograft transplantation was effective in restoring corneal clarity with no development of ocular complications

Avaliaram-se os efeitos do transplante de células tronco autógenas do limbo esclerocórneo de cães, sobre lesões córneo-limbais. Empregaram-se 18 cães, distribuídos em dois grupos, GI e GII. Nos animais do GI (n=12), foram realizados transplantes de limbo, após 30 dias da destruição das células tronco-límbicas. Nos do GII (n=6), realizou-se apenas a destruição do limbo (controle). Aos 3, 7, 15, 30, 60 e 120 dias do transplante de limbo (GI) e aos 33, 37, 45, 60, 90 e 150 dias da destruição do limbo (GII), os olhos foram coletados por enucleação subconjuntival, para estudos em microscopia de luz. A destruição do limbo resultou em completa excisão das células tronco, com perda da transparência corneal. O transplante do limbo evitou a conjuntivalização na área em que foi realizado. Os animais do grupo-controle manifestaram conjuntivalização em 360º e vascularização corneal. Na anatomopatologia, em nenhum dos períodos foi possível distinguir o enxerto do epitélio corneal normal. As células caliciformes foram observadas nos animais do GII, nos períodos 33, 37, 60, 150 dias. No GI, apenas um cão manifestou células caliciformes de forma discreta, aos 60 dias do transplante. O transplante autógeno foi eficiente em possibilitar a melhoria da transparência córnea, sem intercorrências oculares

Preserved amniotic membrane combined with conjunctival autograft transplantation for recurrent symblepharon / 医学研究生学报

Objective:To evaluate the therapeutic effects and value of preserved amniotic membrane combined with conjunctival autograft transplantation for recurrent symblepharon. Methods:A group of 38 eyes in 38 patients with recurrent symblepharon due to recurrent pterygium,chemical burn and other causes were undertaken preserved amniotic membrane combined with conjunctival autograft transplantation.The patients were followed for 6 to 36 monthes.Results:No infections occurred.The amniotic membrane changed into transparent 10 days postoperatively.The conjunctival epithelium emigrated to the surface of amniotic membrane.Impression cytology showed a stable conjunctival epithelium on the surface of amniotic membrane.Efficient movement ability was recovered in 34 eyes(89.5%).Four eyes(10.5%) were still restricted in movement due to partly recurrent symblepharon.Conclusion:The preserved amniotic membrane combined with conjunctival autograft transplantation for is effective recurrent symblepharon

The Clinical Results of Limbal Conjunctival Autograft Transplantation with Intraoperative Mitomycin C Application for Recurrent Pterygia

The recurrence is common problem to treat pterygium. Many surgical procedures were adopted to reduce the recurrence rate. We evaluated the surgical results of limbal conjunctival autograft transplantation (LCAT) accompanying application of 0.02% mitomycin C intraoperatively in 10 patients (10 eyes) who had a recurrent pterygium. There were 7 eyes with first recurrence and 3eyes with second recurrence. Mean age of the patients was 57.4 years, and mean follow-up period was 9.3 months. After a pterygium was excised, a sponge soaked in a solution of mitomycin C 0.02% was applied to the sclera at the site of the surgical bed for 2 minutes, then superior temporal limbal tissue was taken with conjunctival flap and transplanted to the excised area. None of all cases recurred for follow-up period and donor conjunctival site was well reepithelialized. In concluion, LCAT accompanying application of 0.02% mitomycin C intraoperatively was effective and safe method for recurrent pterygium.

Limbal-Conjunctival Autograft Transplantation for the Treatment of Primary Pterygium

Pterygium is a common surgical ocular disease which recurs frequently. Various different techniques have been developed for the successful surgical treatment of pterygium and among them, autograft transplantation is known as the best successful surgical method. For the prevention of recurrence, the corneal epithelium must heal before the fibrovascular tissue grows and reaches to limbus. For this, we have believed that limbal transplanta- tion is more suitable than conjunctival transplantation. We had performed limbal-conjunctival autograft trasplata- tion for 52 patients with primary pterygia whose age was under 40 years old,or whose pterygia had involved above 5mm beyond limbus and had shown diffuse subconjunctival fibrovascular tissue. The recurrence rate was 1.9%and therewere no complications and no surgical problems. Therefore,we recommend this surgical technique as a safe and effective method of treating primary pterygia with the risk factors of recurrence.

2 Cases of Limbal Autograft Transplantation after Chemical/Thermal Corneal Burns

A severe chemical or thermal injury is a troublesome ocular insult, which usually results in persistant corneal epithelial defect, stromal scarring, and neovascularization. For resurfacing chemically burned cornea, limbal autograft transplantation is presented in 2 cases of chemical and/or thermal injury with follow-up of 6, 8 months. The operative technique involved transfer of four free grafts of limbal tissue from the uninjured fellow eye to the severely injured eye. Clinical results of the cases have shown surface healing with stable epithelial adhesion without recurrent erosion or persistant epithelial defect.

The Treatment of Esodeviation with Abduction Deficiency Caused by Recurrent Pterygium

The recurrent pterygium can be caused by repeating excisions for simple pterygium. The severe conjunctival cicatrization on the area of the medial rectus muscle limits abduction and results in diplopia and it is one of the causes of acquired retraction syndrome. We experienced two patients who have marked abducticn limitation and diplopia in all directions of gaze by recurrent pterygium. In order to eliminate these troblesome symptoms and signs with only one surgery, we performed conjunctival autograft transplantation in one patient and on the other patient with bilateral recurrent pterygium, the procedure was performed with resection of the lateral rectus using adjustable suture at one time. The limitation of ocular movement and diplopia were completely gone postoperatively.