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Conjunctival autograft changes after primary pterygium surgery with conjunctival autograft

Poster Details

First Author: E.Mata Diaz SPAIN

Co Author(s):    C. de Pablo   D. Ortiz   B. Jimenez-Rolando   F. Sanchez-Carnerero   M. Bermejo  

Abstract Details



Purpose:

To assess the postoperative healing process of the conjunctival autograft after pterygium surgery with conjunctival autograft fixed with fibrin glue.

Setting:

Hospital de San Jose y Santa Adela ,Madrid, Spain

Methods:

22 eyes of 21 patients having pterygium surgery with conjunctival autograft (ATG) fixed with fibrin glue without other pathology were studied. 20 eyes of 15 patients with no conjunctival pathology were used as control group. A 5 line raster anterior segment optical coherent tomography (AS-OCT) was performed with a ZEISS device in the 42 eyes. The AS-OCT measurements of the ATG were performed 1 week and monthly during 6 months postoperatively in the patients who underwent pterygium surgery . AS-OCT measurements of the bulbar conjunctiva were performed in the 20 eyes of the control group. Main outcome measures: In the control group a histological-tomography correlation of the AS-OCT of the bulbar conjunctiva was obtained and used as baseline to compare with the AS-OCT images of ATG. Measurement of bulbar conjunctiva was made. In the patients group measurement of the conjunctival graft and cornea at the excised area were performed. Corneal epithelisation was assessed. Clinical-tomography correlation was made.

Results:

The average thickness of the bulbar conjunctiva in the control group was 260.5+47.04m (mean+sd). The average thickness of the graft in the patients group was 420+ 197.36 m in the first week. A significant decrease in the graft thickness was observed 1 month after (383.4+89.3m ) needing four months to rich the control group mean value. Corneal epithelium integrity was accomplished at the first week in all cases. The ATG was integrated at the limbus side in the first month, while the nasal area of the ATG was noticeable up to the 4th month. AS-OCT images showed the ATG as an hyperreflective band in which epithelium and sub- epithelial mucosa layer are differentiated from the underlying sclera, usually shown as a shadow in the early postoperative period. The reflectiveness of the conjunctiva decreases, allowing sclera to be shown as a reflective band at the first month postoperatively. Intramucosal cysts were present up to the 6th month. The mean corneal thickness at the excised area was 801.7+ 94.10 m, with no significant changes during the follow-up period.

Conclusions:

Results show that the ATG healing process took four months although clinical healing was attempted in 1 month. AS-OCT proves to be a non-invasive diagnostic tool to evaluate the adequate healing and integration of the ATG. FINANCIAL INTEREST: NONE

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