CONJUNCTIVAL Z-PLASTY FOR PTERYGIUM: COMPARISON WITH CONJUNCTIVAL AUTOGRAFTING

Anahtar Kelimeler:

-

CONJUNCTIVAL Z-PLASTY FOR PTERYGIUM: COMPARISON WITH CONJUNCTIVAL AUTOGRAFTING

Aim: High recurrence rate is the most common problem after the pterygium excision surgery, and the adjunctive therapies performed to reduce the recurrence rate have severe complications. The aim of this study was to compare the safety and efficacy of conjunctival Z-plasty and conjunctival autograft application in primary pterygium surgery. Methods: Forty two consecutive patients had undergone pterygium excision with either conjunctival autografting or conjunctival Z-plasty randomly. Operation time was recorded for each eye. Mean follow-up time in the autograft group and the Z-plasty group was 18 and 17 months, respectively. Results: Loose graft was observed in 1 (4.7%) patient, tenon’s granuloma in 1 (4.7%) patient, and recurrence in 1 patient (4.7%) in the autograft group. Recurrence was observed in 1 patient (4.7%), and suture releasing in 1 patient (4.7%) in the Z-plasty group. Mean operation time was 36.14 ± 3.8 minutes and 16.10 ± 2.0 minutes in the autograft group and the Z-plasty group, respectively (p

Keywords:

Primary pterygium, surgery, conjunctival autografting, conjunctival Z-plasty recurrence,

PDF

___

Jaros PA, DeLuise VP. Pingueculae and pterygia. Surv Ophthalmol 1988;33:41-9
Zauberman H. Pterygium and its recurrence. Am J Ophthalmol 1967;63:1780-6
Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD, Kirkness CM. Conjunctival autografting in the surgical management of pterygium. Eye 1993;7:634-8
Anduze AL. Pterygium surgery with mitomycin-C: ten-year results. Ophthalmic Surg Lasers 2001;32:341-5
Singh G, Wilson MR, Foster GS. Mitomycin eye drops as treatment for pterygium. Ophthalmology 1988;95:813-8
Amano S, Motoyama Y, Oshika T, Eguchi S, Eguchi K. Comparative study of intraoperative mitomycin C and beta irradiation in pterygium surgery. Br J Ophthalmol 2000;84:618-21
Akarsu C, Taner P, Ergin A. 5-Fluorouracil as chemoadjuvant for primary pterygium surgery: preliminary report. Cornea 2003;22:522-6
Kleis WP. Thio-tepa therapy to prevent postoperative pterygium occurrence and neovascularization. Am J Ophthalmol 1973;76:371-3
Singh G, Wilson MR, Foster CS. Long-term follow-up study of mitomycin eye drops as adjunctive treatment of pterygia and its comparison with conjunctival autograft transplantation. Cornea 1990;9:331-4
Kassir MS. Corneal perforation after excision of pterygium and use of 0.02% mitomycin eye drops. J Fr Ophtalmol 1999;22:776-9
Rubinfeld RS, Pfister RR, Stein RM, et al. Serious complications of topical mitomycin C after pterygium surgery. Ophthalmology 1992;99:1647-54
Dunn JP, Seamone CD, Ostler HB, et al. Development of scleral ulceration and calcification after pterygium excision and mitomycin therapy. Am J Ophthalmol 1991;112:343-4
Safianik B, Ben-Zion I, Garzozi HJ. Serious corneoscleral complications after pterygium excision with mitomycin C. Br J Ophthalmol 2002;86:357-8
Kenyon KR, Wagoner MD, Hettinger ME. autograft for advanced and recurrent pterygium. Ophthalmology 1985;92:1461-70
Jap A, Chan C, Lim L, Tan DT. Conjunctival rotation autograft for pterygium. An alternative to conjunctival autografting. Ophthalmology 1999;106:67-71
Ma DH, See LC, Liau SB, Tsai RJ. Amniotic membrane graft for primary pterygium: Comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000;84:973-8
Wilson SE, Bourne WM. Conjunctival Z- plasty in the treatment of pterygium. Am J Ophthalmol 1988;106:355-9
Sharma A, Gupta A, Ram J, Gupta A. Low- dose intraoperative mitomycin-C versus conjunctival autograft in primary pterygium surgery: long term follow-up. Ophthalmic Surg Lasers 2000;31:301-7
Dadeya S, Malik KP, Gulliani BP. Pterygium surgery: Conjunctival rotation autograft versus conjunctival autograft. Ophthalmic Surg Lasers 2002;33:269-74
Kim S, Yang Y, Kim J. Primary pterygium surgery using the inferior conjunctival transposition flap. Ophthalmic Surg Lasers 1998;29:608-11
Hayasaka S, Noda S, Yamamoto Y, Setogawa T. Postoperative instillation of low dose mitomycin-c in the treatment of primary pterygium. Am J Ophthalmol 1988;106:715-8
Mastropasqua L, Carpineto P, Ciancaglini M, Gallenga PE. Long-term results of intra- operative mitomycin C in the treatment of recurrent pterygium. Br J Ophthalmol 1996;80:288-91
Lam DS, Wong AK, Fan DS, et al. Intra- operative mitomycin-C to prevent the recurrence of pterygium after excision. Ophthalmology 1998;105:901-5
Panda A, Das GK, Tuli SW, Kumar A. Randomized trial of intra-operative mitomycin C in surgery for pterygium. Am J Ophthalmol 1998;125:59-63
Dougherty PJ, Hardten DR, Lindstrom RL. Corneoscleral melt after pterygium surgery using single intraoperative application of mitomycin C. Cornea 1996;15:537-40
Stark T, Kenyon KR, Serrano E. Conjunctival autograft for primary and recurrent pterygia: surgical technique and problem management. Cornea 1991;10:196-202
Sanchez-Thorin JC, Rocha G, Yelin JB. Meta-analysis on the recurrence rates after bare sclera resection with and without mitomycin C use and conjunctival autograft placement in surgery for primary pterygium. Br J Ophthalmol 1998; 82:661-5
Lawalllen S. A randomized trial conjunctival autografting for pterygium in the tropics. Ophthalmology 1989;96:1612-4
Chen PP, Ariyasu RG, Kaza V. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120:151-60
Guler M, Sabci G, Ilker S, Ozturk F, Mutlu FM, Yildirim E. Limbal-conjunctival autograft transplantation in cases with recurrent pterygium. Acta Ophthalmol (Cophen) 1994; 72:721-6