Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Ophthalmology Department, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
Cornea. 2021 Jan;40(1):43-47. doi: 10.1097/ICO.0000000000002336.
To report on the outcomes of recurrent pterygium treated by ipsilateral simple limbal epithelial transplantation (SLET), mitomycin, tenonectomy, and amniotic membrane transplantation.
A retrospective, interventional study was conducted including all patients with recurrent pterygium who underwent SLET surgery under a single surgeon using ipsilateral donor tissue with a minimum 6-month follow-up at Toronto Western Hospital, Canada. Outcome measures included the following: recurrence rates, best spectacle-corrected visual acuity, and postoperative complications.
Ten eyes of 10 patients, aged 60.7 ± 18.5 years (range 23-79) with a mean follow-up time of 15.2 ± 10.0 months of which 50% (n = 5) were men, were included. Eight eyes (80%) had a history of 2 or less pterygium operations. Two patients had 3 and 5 previous pterygium operations, respectively. Concurrent limbal stem cell disease was noted in 6 eyes (60%). Average number of pterygium recurrences per eye was 1.9 ± 1.3 (range 1-5). Mean pre-op best-corrected visual acuity was 0.5 LogMAR (Snellen equivalent 20/60, range 20/20 to counting fingers). Best-corrected visual acuity remained the same or improved in 6 eyes (60%). Recurrence was noted in 1 eye (10%) with a history of 5 previous pterygium excisions and remained stable at the last follow-up. No patients required a second operation.
Ipsilateral SLET with mitomycin, tenonectomy, and amniotic membrane transplantation is a novel technique to address recurrent pterygium. Concurrent limbal stem cell diseases are often present. Initial results demonstrate low recurrence. Visual improvement is modest. Stabilization of the ocular surface to improve vision is possible.
报告同侧单纯性角膜缘上皮移植（SLET）、丝裂霉素、腱膜切除术和羊膜移植治疗复发性翼状胬肉的结果。
这是一项回顾性的干预性研究，包括所有在加拿大多伦多西部医院由同一位外科医生进行 SLET 手术的复发性翼状胬肉患者，这些患者均使用同侧供体组织，随访时间至少为 6 个月。主要观察指标包括复发率、最佳矫正视力和术后并发症。
共纳入 10 例 10 眼患者，年龄 60.7±18.5 岁（范围 23-79 岁），平均随访时间 15.2±10.0 个月，其中 50%（n=5）为男性。8 只眼（80%）有 2 次或更少的翼状胬肉手术史，2 只眼（20%）分别有 3 次和 5 次翼状胬肉手术史。6 只眼（60%）存在角膜缘干细胞疾病。每只眼的翼状胬肉复发次数平均为 1.9±1.3 次（范围 1-5 次）。术前最佳矫正视力平均为 0.5 LogMAR（Snellen 等效视力 20/60，范围 20/20 至指数）。6 只眼（60%）的最佳矫正视力保持不变或提高。1 只眼（10%）有 5 次翼状胬肉切除术史，出现复发，但在最后一次随访时仍保持稳定。无患者需要再次手术。
同侧 SLET 联合丝裂霉素、腱膜切除术和羊膜移植是治疗复发性翼状胬肉的一种新方法。常伴有角膜缘干细胞疾病。初步结果显示复发率低，视力改善程度较小，但可稳定眼表以改善视力。
