Emilio Pedrotti1, Marina Bertolin2, Adriano Fasolo3,4, Erika Bonacci1, Francesca Bosello1, Diego Ponzin2, Giorgio Marchini1. 1. Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy. 2. Research Unit, The Veneto Eye Bank Foundation (Fondazione Banca degli Occhi del Veneto), Pad. G. Rama, Via Paccagnella 11, 30174, Venezia, Italy. 3. Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy. adriano.fasolo@yahoo.it. 4. Research Unit, The Veneto Eye Bank Foundation (Fondazione Banca degli Occhi del Veneto), Pad. G. Rama, Via Paccagnella 11, 30174, Venezia, Italy. adriano.fasolo@yahoo.it.
Abstract
PURPOSE: To evaluate the feasibility of a new method of conjunctival transplantation to achieve recovery of the normal conjunctival epithelium over the bare sclera after pterygium excision and prevent its recurrence. METHODS: After excision of the primary pterygium, we performed simple conjunctival epithelial transplantation (SCET) in which we glued an amniotic membrane patch pre-loaded with tiny autologous conjunctival tissue fragments over the scleral defect. Slit-lamp evaluation was performed at 2 and 7-10 days, and then at 1, 3, 6, and 12 months after surgery, together with confocal microscopy at 3, 6, and 12 months. RESULTS: Surgical excision and SCET for nasal primary pterygium were performed in 6 eyes (6 patients). No graft detachment occurred. An inflammatory granuloma was excised without sequelae in one patient 2 months after surgery. No signs of recurrence or sight-threatening complications were recorded at 12 months, and in vivo confocal microscopy showed progressive expansion of the conjunctival cell population and formation of a clear corneal-conjunctival transition. CONCLUSIONS: SCET takes advantage of the ability of the amniotic membrane and conjunctival cells to renew. Outcomes after SCET are comparable to conventional conjunctival flap surgery and can be achieved in less surgical time and with less donor tissue to be removed.
PURPOSE: To evaluate the feasibility of a new method of conjunctival transplantation to achieve recovery of the normal conjunctival epithelium over the bare sclera after pterygium excision and prevent its recurrence. METHODS: After excision of the primary pterygium, we performed simple conjunctival epithelial transplantation (SCET) in which we glued an amniotic membrane patch pre-loaded with tiny autologous conjunctival tissue fragments over the scleral defect. Slit-lamp evaluation was performed at 2 and 7-10 days, and then at 1, 3, 6, and 12 months after surgery, together with confocal microscopy at 3, 6, and 12 months. RESULTS: Surgical excision and SCET for nasal primary pterygium were performed in 6 eyes (6 patients). No graft detachment occurred. An inflammatory granuloma was excised without sequelae in one patient 2 months after surgery. No signs of recurrence or sight-threatening complications were recorded at 12 months, and in vivo confocal microscopy showed progressive expansion of the conjunctival cell population and formation of a clear corneal-conjunctival transition. CONCLUSIONS: SCET takes advantage of the ability of the amniotic membrane and conjunctival cells to renew. Outcomes after SCET are comparable to conventional conjunctival flap surgery and can be achieved in less surgical time and with less donor tissue to be removed.