J Korean Ophthalmol Soc > Volume 59(12); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(12):1114-1121.
DOI: https://doi.org/10.3341/jkos.2018.59.12.1114    Published online December 15, 2018.
Long-term Outcomes of Conjunctivo-limbal Autograft Alone and Additional Widening of Limbal Incision in Recurrent Pterygia.
In Kwon Chung, Jin Hyoung Kim, Jong Hyun Lee, Do Hyung Lee
Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. eyedr0823@hotmail.com
군날개 재발에 있어서 자가윤부결막이식술 단독 및 추가 윤부절개술의 장기 결과
정인권⋅김진형⋅이종현⋅이도형
인제대학교 의과대학 일산백병원 안과학교실
Correspondence:  Do Hyung Lee,
Email: eyedr0823@hotmail.com
Received: 6 September 2018   • Revised: 21 November 2018   • Accepted: 30 November 2018
Abstract
PURPOSE
We report the clinical outcomes of patients undergoing additional widening of the limbal incision to prevent disease recurrence after conjunctivo-limbal autograft combined with pterygial excision. METHODS: We retrospectively compared 95 eyes with primary and 12 eyes with recurrent pterygia randomized to treatment via two surgical methods: conjunctivo-limbal autograft alone and combined with widening of the limbal incision to allow for pterygial removal. We widened the limbal incisions by 1 mm on both the superior and inferior limbal margins and removed the pterygia. The outcomes were compared between 39 eyes undergoing conjunctivo-limbal autograft alone and 68 eyes undergoing conjunctivo- limbal autograft with widening of the limbal incision. RESULTS: The mean overall postoperative follow-up period was 29.6 ± 10.5 months and conjunctivo-limbal autograft alone group was 27.4 ± 11.5 months, combined with widening of the limbal incision group was 30.7 ± 9.7 months. Six pterygia (15.4%; four primary and two recurrent) developed in those undergoing conjunctivo-limbal autograft alone and two (2.9%; one primary and one recurrent) in those undergoing additional widening of the limbal incision; the recurrence rate differed significantly between the two groups (p < 0.05). In the group treated with conjunctivo-limbal autograft alone, the mean time to development of a new primary pterygium was 6.3 ± 3.4 months and that to development of a recurrent pterygium 4.3 ± 2.5 months; the respective values for the group undergoing additional widening of the limbal incision were 12.1 ± 2.6 and 8.4 ± 4.6 months; the recurrence rates differed significantly (p < 0.05). CONCLUSIONS: Conjunctivo-limbal autograft with additional widening of the limbal incision used to treat both new primary and recurrent pterygia was more effective in terms of reducing pterygial recurrence than conjunctivo-limbal aAutograft alone.
Key Words: Limbal;Pterygium;Recurrence;Transplantation;Widening


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