Recurrencia de pterigión operado con autoinjerto conjuntivo-limbar por residentes en la clínica CES / Recurrence of pterygium after conjunctival limbal auto-graft by residents at the CES clinic

Introducción: El pterigión es una lesión fibrovascular, hiperplásica de tejido conjuntival, que crece sobre la córnea por alteración de las células madre que participan en la regeneración del tejido. Su manejo es quirúrgico y el éxito depende del tipo de técnica utilizada. Los reportes más bajos de recurrencia y complicaciones postoperatorias se han encontrado con la técnica de autoinjerto conjuntivo-limbar. Objetivo: Establecer la recurrencia a un año en pacientes sometidos a cirugía pterigión primario con autoinjerto conjuntivo-limbar operados por residentes de oftalmología de primer año en la Clínica CES en el periodo 2015 a 2018. Diseño del estudio: Seguimiento retrospectivo a una cohorte. Método: Se realizó un muestreo probabilístico simple del 10% (110 historias clínicas) de los registros de los pacientes intervenidos entre 2015 y 2018. Resultados: El 55.7% fue mujeres, el promedio de edad fue 45 (33-61) años y se encontró una recurrencia de pterigión del 7.6% a un año. Conclusión: La recurrencia de pterigión primario intervenidos por residentes de primer año con la técnica de autoinjerto conjuntivo-limbar está dentro de lo reportado en estudios realizados con cirujanos de mayor experiencia

Background: Pterygium is a fibrovascular, hyperplastic lesion of conjunctival tissue, which grows on the cornea due to alteration of the stem cells that participate in tissue regeneration. Its management is surgical, and its success depends on the type of technique used. The lowest reports of recurrence and postoperative complications have been found with the conjunctive-limbar autograft technique. Objective: To establish the one-year recurrence in patients undergoing primary pterygium surgery with limbar-conjuntival autograft operated by first-year ophthalmology residents at the CES Clinic in the period 2015 to 2018. Study design: Follow-up to a retrospective cohort. Method: A simple probability sampling of 10% (110 medical records) was carried out of the records of the patients operated between 2015 and 2018. Results: 55.7% were women, the average age was 45 (33-61) years, and it was found a recurrence of pterygium of 7.6% at one year. Conclusion: The recurrence of primary pterygium operated by first-year residents with limbar-conjunctival autograft technique is within that reported in studies carried out with more experienced surgeons

Symptomatic management of postoperative bullous keratopathy with nonpreserved human amniotic membrane.

PURPOSE: To report the results of the management of painfully symptomatic postoperative bullous keratopathy (PBK) by performing a nonpreserved human amniotic membrane (NP-AMT) transplantation in nine eyes with poor visual potential. METHODS: A prospective, comparative, nonrandomized management of symptomatic PBK was done by performing a complete corneal de-epithelialization followed by a NP-AMT transplantation (NP-AMT group) or no NP-AMT transplantation (control group). We evaluated time for re-epithelialization, patient's symptoms, and appearance of new bullae. RESULTS: In the NP-AMT group, mean follow-up time was 40 weeks. Mean re-epithelialization time was 11.2 days. Symptoms of PBK resolved completely in eight patients (88%), who were asymptomatic and showing very quiet eyes from postoperative day 1, and resolved partially in one patient in whom we observed barely symptomatic bullae at the peripheral NP-AMT border (sixth postoperative week) and an asymptomatic one at the corneal center under the NP-AMT (seventh postoperative week). In the control group, mean follow-up time was 18 weeks; there were recurrences of symptomatic bullae in four of five patients at a mean time of 6.3 days. CONCLUSIONS: NP-AMT is a good alternative for the management of painful PBK in eyes with poor visual potential; NP-AMT is widely available, the technique is easy to perform, and it has good results from both the symptomatic and esthetic standpoint.