Management of pterygium surgery: Limbal Conjunctival Autograft and Subconjunctival Amniotic Membrane Graft

Authors

  • Reisyah Syahfira Universitas Lampung
  • Putu Ristyaning Ayu Sangging universitas lampung
  • Rani Himayani universitas lampung

DOI:

https://doi.org/10.53089/medula.v13i4.1.751

Abstract

Pterygium is one of the common ocular surface disorders. From two Greek words, the word "pterygium" has been derived: “pteryx” meaning wing and “pterygion” meaning fin. Usually, pterygium is asymptomatic apart from its appearance. Meanwhile, no special examination is needed to diagnose it, only a physical examination is needed using a slit lamp to diagnose this condition. A slit lamp for observing the eye using magnification and bright lighting. Medical treatment in modern times includes lubrication with artificial tear drops or decongestants to provide short-term comfort and a slight improvement in cosmetics. Topical NSAIDs, eye drop loteprednol, brings added comfort. Vasoconstrictive agents minimize redness and enhance the appearance and add antihistamines to the decongestant drops to help prevent the effect of histamine associated edema and itching. However, surgical treatment remains the preferred option. In patients with pterygium, the reasons for surgery are decreased vision due to visual axis encroachment, chronic pain, persistent inflammation, abnormal astigmatism, restrictive ocular motility, and cosmesis. Many surgical techniques have been used since past to present, though none is universally accepted because of variable recurrence rates. Some examples of surgery, namely the avulsion technique, Simple excision technique, The Bare Sclera Technique, Conjunctival Autograft, and Limbal Conjunctival Autotransplant (LCAT). However, combined between limbal conjunctival autograft with the adjunctive use of a prophylactic subconjunctival graft of the amniotic membrane can decrease the recurrence rate after surgery in an ethnically diverse population with a statistically higher risk for recurrence.

References

ROSENTHAL JW. Kronologi terapi pterigium. Am J Ophthalmol. November 1953; 36(11):1601-16. [PubMed].

Ang M, Li X, Wong W, Zheng Y, Chua D, Rahman A, Saw SM, Tan DT, Wong TY. Prevalence of and racial differences in pterygium: a multiethnic population study in Asians. Ophthalmology. 2012 Aug;119(8):1509-15. [PubMed]

Farhad Rezvan, Mehdi Khabazkhoob, Elham Hooshmand, Abbasali Yekta, Mohammad Saatchi, Hassan Hashemi. Prevalence and risk factors of pterygium: a systematic review and meta-analysis. 2018. DOI:https://doi.org/10.1016/j.survophthal.2018.03.001

Zeitz, O. Myron Yanoff and Jay S. Duker: Ophthalmology, Fifth Edition. Graefes Arch Clin Exp Ophthalmol 258, 459 (2020). https://doi.org/10.1007/s00417-019-04489-7

Moran DJ, Hollows FC. Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol 1984; 68: 343–346. [Europe PMC free article] [Abstract] [Google Scholar]

Taylor HR, West SK, Rosenthal FS, et al.. Corneal changes associated with chronic UV irradiation. Arch Ophthalmol 1989; 107: 1481–1484. [Abstract] [Google Scholar]

Gallagher MJ, Giannoudis A, Herrington CS, et al.. Human papillomavirus in pterygium. Br J Ophthalmol 2001; 85: 782–784. [Europe PMC free article] [Abstract] [Google Scholar]

Chalkia AK, Spandidos DA, Detorakis ET. Viral involvement in the pathogenesis and clinical features of ophthalmic pterygium (Review). Int J Mol Med 2013; 32: 539–543. [Europe PMC free article] [Abstract] [Google Scholar]

Anguria P, Kitinya J, Ntuli S, et al.. The role of heredity in pterygium development. Int J Ophthalmol 2014; 7: 563–573. [Europe PMC free article] [Abstract] [Google Scholar]

Pinkerton OD, Hokama Y, Shigemura LA. Immunologic basis for the pathogenesis of pterygium. Am J Ophthalmol 1984; 98: 225–228. [Abstract] [Google Scholar]

Hill JC, Maske R. Pathogenesis of pterygium. Eye 1989; 3: 218–226.

Nubile M, Curcio C, Lanzini M, et al.. Expression of CREB in primary pterygium and correlation with Cyclin D1, ki-67, MMP7, p53, p63, survivin and vimentin. Ophthalmic Res 2013; 50: 99–107. [Abstract] [Google Scholar]

Tong L, Li J, Chew J, et al.. Phospholipase D in the human ocular surface and in pterygium. Cornea 2008; 27: 693–698. [Abstract] [Google Scholar]

Peng M-L, Tsai Y-Y, Chiang C-C, et al.. CYP1A1 protein activity is associated with allelic variation in pterygium tissues and cells. Mol Vis 2012; 18: 1937–1943. [Europe PMC free article] [Abstract] [Google Scholar]

Ortak H, Cayli S, Ocakli S, et al.. Increased expression of aquaporin-1 and aquaporin-3 in pterygium. Cornea 2013; 32: 1375–1379.

Tan DT, Chee SP, Dear KB, et al.. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 2002; 115: 1235–1240. [Abstract] [Google Scholar]

Maheshwari S. Pterygium-induced corneal refractive changes. Indian J Ophthalmol 2007; 55: 383–386.

Rong SS, Peng Y, Liang YB, Cao D, Jhanji V. Apakah merokok mengubah risiko pterygium? Tinjauan sistematis dan meta-analisis. Investasikan Ophthalmol vis Sci. 2014 Sep 04; 55(10):6235-43. [PubMed]

Aminlari A, Singh R, Liang D. Management of pterygium. Ophthalmic Pearls. Cornea. 2014;37–38.

Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016. doi:10.1002/14651858.CD011349.

Fernandes M, Sangwan VS, Bansal AK, et al. Outcome of pterygium surgery: analysis over 14 years. Eye. 2005;19(11):1182–1190. doi:10.1038/sj.eye.6701728

Kandavel R, Kang JJ, Memarzadeh F, et al. Comparison of pterygium recurrence rates in hispanic and white patients after primary excision and conjunctival autograft. Cornea. 2010;29(2):141–145. doi:10.1097/ico.0b013e3181b11630

Published

2023-06-07

How to Cite

Syahfira, R., Sangging, P. R. A. ., & Himayani, R. . (2023). Management of pterygium surgery: Limbal Conjunctival Autograft and Subconjunctival Amniotic Membrane Graft. Medical Profession Journal of Lampung, 13(4.1), 190-195. https://doi.org/10.53089/medula.v13i4.1.751

Most read articles by the same author(s)

1 2 3 4 5 6 7 > >>