Oh Joo Youn, Khwarg Sang In
Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Front Med (Lausanne). 2024 Oct 23;11:1452579. doi: 10.3389/fmed.2024.1452579. eCollection 2024.
A 40-year-old woman visited our clinic for recurred pterygium and symblepharon in the right eye. She had a history of pterygium excision 8 years before. Over the course of 7 years, we performed pterygium excision combined initially with mitomycin C (MMC) application and conjunctival autograft. This was followed by three procedures using limbal allografts, MMC application, and amniotic membrane transplantation. All procedures were unsuccessful, resulting in aggressive recurrences of pterygial mass and symblepharon, extraocular movement limitation, corneal astigmatism, and decreased visual acuity. Ultimately, we applied a labial mucosal autograft after the recession of pterygial tissue. No complications were observed. Two and a half years postoperatively, the labial mucosal autograft was well-integrated into the conjunctival surface without symblepharon recurrence or abduction limitation. Corneal clarity was restored, and astigmatism was reduced, with no recurrence of pterygium. In conclusion, a labial mucosal autograft is a viable treatment option in complex cases of recalcitrantly recurrent pterygium with symblepharon.
一名40岁女性因右眼复发性翼状胬肉和睑球粘连前来我院就诊。她8年前有翼状胬肉切除病史。在7年的病程中，我们最初进行了翼状胬肉切除联合丝裂霉素C（MMC）应用及结膜自体移植。随后进行了三次使用角膜缘异体移植、MMC应用和羊膜移植的手术。所有手术均未成功，导致翼状胬肉肿块和睑球粘连的侵袭性复发、眼球运动受限、角膜散光和视力下降。最终，在翼状胬肉组织退缩后，我们应用了唇黏膜自体移植。未观察到并发症。术后两年半，唇黏膜自体移植与结膜表面良好整合，无睑球粘连复发或外展受限。角膜透明度恢复，散光减少，翼状胬肉未复发。总之，唇黏膜自体移植是治疗复发性翼状胬肉合并睑球粘连复杂病例的一种可行选择。
