Treatment Of Recurrence Pterygium Using Stromal Lentiucule Via Smile Surgery As Allogenic Corneal Patch Graft

To present successful management of recurrence pterygium using stromal lenticule via taken from SMILE surgery as corneal patch graft.

The aim of the study is  to see the effect of stromal corneal lenticule as corneal patch graft which obtained after SMILE surgery in prevention of recurrence of pterygium disease and to assess the efficacy of the injections of  0.5 ml platelet rich plasma (PRP) at the end of surgery.

Eye Hospital,Department of Ophthlamology, Prishtina,Kosovo

Methods: A 40-year-old male patient, referred to our clinic for his  recurrent pterygium for 10 years. He was a field worker, smoker and had a family history of pterygium. . His visual acuity was full in both eyes. On slit-lamp examination, he had bilateral recurrent pterygium. He had no history of any ocular surgery except for pterygium surgery 10 years ago in both eyes. He did not remember the method of previous pterygium surgery and his past medical documents were not available.

Successful excision for d pterygium was made under local anesthesia in the right eye after receiving a signed informed consent.The donor and recipient patient are organized to perform the surgical interventions on the same day.After the SMILE procedure for the correction of the minus diopter, the received lenticule is placed for 10 minutes in the BSS. After that the lenticule graft was put to recepient patient and sutured to the surrounding conjunctiva by interrupted 8/0 vicryl. At the end of surgery, we give 0.5 ml  PRP -plasam rich platelets subconjunctivaly.

Results:  At postoperative first week, first and 3 month visits, conjunctival allograft was in place and stable.Following operation the patient received corticosteroid-antibiotic eye drops  4 times a day, lubricant eye drop (PRP 50 %, ) for 1 month.  No complications such as infection, corneal thinning or graft dislocation were seen. 

Conclussion :We suggest stromal lenticule as corneal patch graft for pterigum surgery as a safe and useful surgical method for the treatment of recurrent pterygium; however, longer follow-up is required to confirm the outcome.