Sati Alok, Mishra Sanjay Kumar, Shukla Sarvadarshi, Unni Deepesh, Kumar Sonali V, Dhar Sanjay Kumar, Kaushik Jaya, Sharma Vijay Kumar, Pannu Anju
Department of Ophthalmology, Cornea and Anterior Segment Services, Army Hospital (Research and Referral), New Delhi, India.
Department of Hospital Administration, AMC Centre and College, Lucknow, Uttar Pradesh, India.
Indian J Ophthalmol. 2025 Jun 1;73(Suppl 3):S517-S523. doi: 10.4103/IJO.IJO_1413_24. Epub 2024 Dec 27.
We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e., pterygium extended removal (PER) (removal of tenon capsule with fibrovascular tissue around medial rectus from limbus till medial canthus) followed by minor ipsilateral limbal epithelial transplantation (coverage of bare sclera with amniotic membrane graft and placement of ipsilateral limbal pieces at the affected limbus). The patients were reviewed on day 1, day 7, and day 30 and at third, sixth, and twelfth month after surgery, and none of the eyes (0/9) showed recurrence of pterygium on to the cornea. Time taken for surgery was 53.88 ± 8.74 minutes (range, 45 to 75 minutes). Postoperative discomfort (pain, irritation, foreign body sensation, and lacrimation) persisted mainly for day 1 after the surgery. However, lacrimation persisted till day 7 in two of the patients. Intraoperative complications were seen in none of the eyes. A total of 1/9 patients had granuloma formation, and 1/9 had dellen formation in postoperative period with successful management. Moreover, none of the eyes (0/9) developed ocular motility restrictions in postoperative period. PERMISLET, an innovative surgical technique for recurrent pterygium, is a viable option with zero rate of recurrence and minimal complications, a boon for patients with limited healthy conjunctiva or a potential for future glaucoma drainage procedures.
我们描述了一种针对复发性翼状胬肉的新技术，并从复发率、术后症状、术后眼位矫正以及其他并发症方面评估了扩大的眼球筋膜囊切除术、羊膜移植和角膜缘上皮移植的优势。共有9只患有复发性翼状胬肉的眼睛接受了PERMISLET手术，即翼状胬肉扩大切除术（PER）（从角膜缘至内眦切除内直肌周围带有纤维血管组织的眼球筋膜囊），随后进行同侧微小角膜缘上皮移植（用羊膜移植覆盖裸露的巩膜，并在患侧角膜缘放置同侧角膜缘组织块）。在术后第1天、第7天、第30天以及术后第3个月、第6个月和第12个月对患者进行了复查，没有一只眼睛（0/9）出现翼状胬肉复发至角膜的情况。手术时间为53.88±8.74分钟（范围为45至75分钟）。术后不适（疼痛、刺激感、异物感和流泪）主要在术后第1天持续存在。然而，两名患者的流泪症状一直持续到第7天。术中没有一只眼睛出现并发症。共有1/9的患者在术后出现肉芽肿形成，1/9的患者出现角膜小凹形成，但均成功处理。此外，没有一只眼睛（0/9）在术后出现眼球运动受限的情况。PERMISLET是一种用于复发性翼状胬肉的创新手术技术，是一种可行的选择，复发率为零且并发症极少，对于健康结膜有限或未来有青光眼引流手术可能性的患者来说是一大福音。
