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Pilot study of a glue-less, suture-less amniotic membrane for pterygium excision

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Abstract

Purpose

Pterygium is a non-cancerous, fibrovascular growth of the bulbar conjunctiva that can cause visual disturbance, ocular pain, and cosmetic concerns. Surgical management is required in certain cases, which consists of excising the pterygium and associated Tenon’s, then overlaying the bare sclera with an autograft or amniotic membrane using glue or sutures. The purpose of this study is to assess outcomes of pterygium repair using a newly developed self-adhesive amniotic membrane that does not require glue or sutures for fixation.

Methods

Chart review of pterygium excision using a new self-adhesive amniotic membrane from a single surgical practice from 2012-2018. Descriptive statistics from 51 primary cases of pterygium excision were included.

Results

Pterygium recurrence occurred in 3 of the 51 self-adhesive amniotic membrane cases studied, resulting in a recurrence rate of 5.9%. Pterygium excision with the self-adhesive amniotic membrane had high rate of pyogenic granuloma formation of 27%. Self-adhesive amniotic membranes were found to perform comparably to more widely used techniques for pterygium excision, namely amniotic membranes and conjunctival autographs with glue or sutures. However, the self-adhesive grafts are associated with substantially more pyogenic granuloma formation.

Conclusion

Self-adhesive amniotic membranes offer comparable efficacy for preventing pterygium recurrence in comparison to other amniotic membranes and the conjunctival autograft. The incidence of pyogenic granuloma formation is higher in self-adhesive grafts compared to other widely used options.

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References

  1. Bondalapati S, Ambati B (2016) Minimally invasive pterygium surgery: sutureless excision with amniotic membrane and hydrogel sealant. Case Rep Ophthalmol 7(1):79–84. https://doi.org/10.1159/000444076

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kucukerdonmez C, Akova YA, Altinors DD (2007) Comparison of conjunctival autograft with amniotic membrane transplantation for pterygium surgery: surgical and cosmetic outcome. Cornea 26(4):407–413. https://doi.org/10.1097/ICO.0b013e318033b3d4

    Article  PubMed  Google Scholar 

  3. Prajna NV, Devi L, Seeniraj SK, Keenan JD (2016) Conjunctival autograft versus amniotic membrane transplantation after double pterygium excision: a randomized trial. Cornea 35(6):823–826. https://doi.org/10.1097/ico.0000000000000812

    Article  PubMed  Google Scholar 

  4. Clearfield E, Muthappan V, Wang X, Kuo IC (2016) Conjunctival autograft for pterygium. Cochrane Database Syst Rev 2:CD011349. https://doi.org/10.1002/14651858.CD011349.pub2

    Article  PubMed  Google Scholar 

  5. Noureddin GS, Yeung SN (2016) The use of dry amniotic membrane in pterygium surgery. Clin Ophthalmol 10:705–712. https://doi.org/10.2147/OPTH.S80102

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Malla T, Jiang J, Hu K (2018) Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery. Int J Ophthalmol 11(3):395–400. https://doi.org/10.18240/ijo.2018.03.08

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rosen R (2018) Amniotic membrane grafts to reduce pterygium recurrence. Cornea 37(2):189–193. https://doi.org/10.1097/ico.0000000000001407

    Article  PubMed  Google Scholar 

  8. Marsit N, Gafud N, Kafou I et al (2016) Safety and efficacy of human amniotic membrane in primary pterygium surgery. Cell Tissue Bank 17(3):407–412. https://doi.org/10.1007/s10561-016-9554-9

    Article  PubMed  Google Scholar 

  9. Tanaka TS, Demirci H (2016) Cryopreserved ultra-thick human amniotic membrane for conjunctival surface reconstruction after excision of conjunctival tumors. Cornea 35(4):445–450. https://doi.org/10.1097/ico.0000000000000737

    Article  PubMed  Google Scholar 

  10. Kheirkhah A, Casas V, Sheha H, Raju VK, Tseng SC (2008) Role of conjunctival inflammation in surgical outcome after amniotic membrane transplantation with or without fibrin glue for pterygium. Cornea 27(1):56–63. https://doi.org/10.1097/ICO.0b013e31815873da

    Article  PubMed  Google Scholar 

  11. Sharma A, Raj H, Gupta A, Raina AV (2015) sutureless and glue-free versus sutures for limbal conjunctival autografting in primary pterygium surgery: a prospective comparative study. J Clin Diagn Res 9(11):NC06-09. https://doi.org/10.7860/JCDR/2015/15689.6789

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Sekiyama E, Nakamura T, Kurihara E et al (2007) Novel sutureless transplantation of bioadhesive-coated, freeze-dried amniotic membrane for ocular surface reconstruction. Invest Ophthalmol Vis Sci 48(4):1528–1534. https://doi.org/10.1167/iovs.06-1104

    Article  PubMed  Google Scholar 

  13. Zhang Z, Yang Z, Pan Q, Chen P, Guo L (2018) Clinicopathologic characteristics and the surgical outcome of conjunctival granulomas after pterygium surgery. Cornea 37(8):1008–1012. https://doi.org/10.1097/ico.0000000000001647

    Article  PubMed  Google Scholar 

  14. Ma DH, See LC, Liau SB, Tsai RJ (2000) Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 84(9):973–978. https://doi.org/10.1136/bjo.84.9.973

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Toker E, Eraslan M (2016) Recurrence after primary pterygium excision: amniotic membrane transplantation with fibrin glue versus conjunctival autograft with fibrin glue. Curr Eye Res 41(1):1–8. https://doi.org/10.3109/02713683.2014.999947

    Article  CAS  PubMed  Google Scholar 

  16. Allen CL, Clare G, Stewart EA et al (2013) Augmented dried versus cryopreserved amniotic membrane as an ocular surface dressing. PLoS ONE 8(10):e78441. https://doi.org/10.1371/journal.pone.0078441

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Tighe S, Mead OG, Lee A, Tseng SCG (2020) Basic science review of birth tissue uses in ophthalmology. Taiwan J Ophthalmol 10(1):3–12. https://doi.org/10.4103/tjo.tjo_4_20

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cooke M, Tan EK, Mandrycky C, He H, O'Connell J, Tseng SC 2014 Comparison of cryopreserved amniotic membrane and umbilical cord tissue with dehydrated amniotic membrane/chorion tissue. J Wound Care 23(10):465–474, 476. https://doi.org/10.12968/jowc.2014.23.10.465.

  19. Tseng SC (2016) HC-HA/PTX3 Purified From Amniotic Membrane as Novel Regenerative Matrix: Insight Into Relationship Between Inflammation and Regeneration. Invest Ophthalmol Vis Sci 57(5):ORSFh1-8. https://doi.org/10.1167/iovs.15-17637

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Wolters JEJ, van Mechelen RJS, Al Majidi R et al (2021) History, presence, and future of mitomycin C in glaucoma filtration surgery. Curr Opin Ophthalmol 32(2):148–159. https://doi.org/10.1097/icu.0000000000000729

    Article  PubMed  Google Scholar 

  21. da Costa PC, Julio G, Campos P, Pujol P, Asaad M (2017) Effects of mitomycin C in early conjunctival inflammation after pterygium surgery. Curr Eye Res 42(5):696–700. https://doi.org/10.1080/02713683.2016.1236965

    Article  CAS  Google Scholar 

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Correspondence to Ezan A. Kothari.

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Kothari, E.A., Tenewitz, J.E., Jayman, J.R. et al. Pilot study of a glue-less, suture-less amniotic membrane for pterygium excision. Int Ophthalmol 42, 2933–2938 (2022). https://doi.org/10.1007/s10792-022-02281-x

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  • DOI: https://doi.org/10.1007/s10792-022-02281-x

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