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Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:5844973. [PMID: 36101796 PMCID: PMC9462984 DOI: 10.1155/2022/5844973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022]
Abstract
Objective The aim of the study is to evaluate the safety and effectiveness of amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space. Methods This study retrospectively included 100 patients with primary pterygium who received closed bulbar conjunctiva and tenon capsule space combined with amniotic membrane transplantation in our hospital from January 2020 to June 2021 as the experimental group and 100 patients with routine treatment in the same period as the control group. The postoperative efficacy evaluation and postoperative complications of the two groups were compared, so as to comprehensively evaluate the safety and effectiveness of this method. Results The results showed that the postoperative complications of the two groups were significantly improved by Fisher's exact test (χ2 = 14.510, P = 0.006 < 0.05). The comparison results showed that the treatment group showed significant advantages in six indexes compared with the observation group and the difference between the two groups was statistically significant (P < 0.05) of in the NRS score, Prabhasawat score, inspection of the ocular surface comprehensive analyzer, corneal fluorescein staining, conjunctival fluorescein staining in the operation area, breakup time of tear film examination of the two groups at 3, 7 and 14 days, and 1, 6 and 12 months after the operation. Conclusions Amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space is safer than conventional surgery in the treatment of primary pterygium. It has a shorter recovery time, higher safety, and a positive curative effect. It can be considered to popularize this operation in clinic.
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Pedrotti E, Bertolin M, Fasolo A, Bonacci E, Bosello F, Ponzin D, Marchini G. Autologous simple conjunctival epithelial transplantation for primary pterygium. Int Ophthalmol 2022; 42:3673-3680. [PMID: 35612687 DOI: 10.1007/s10792-022-02364-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/28/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the feasibility of a new method of conjunctival transplantation to achieve recovery of the normal conjunctival epithelium over the bare sclera after pterygium excision and prevent its recurrence. METHODS After excision of the primary pterygium, we performed simple conjunctival epithelial transplantation (SCET) in which we glued an amniotic membrane patch pre-loaded with tiny autologous conjunctival tissue fragments over the scleral defect. Slit-lamp evaluation was performed at 2 and 7-10 days, and then at 1, 3, 6, and 12 months after surgery, together with confocal microscopy at 3, 6, and 12 months. RESULTS Surgical excision and SCET for nasal primary pterygium were performed in 6 eyes (6 patients). No graft detachment occurred. An inflammatory granuloma was excised without sequelae in one patient 2 months after surgery. No signs of recurrence or sight-threatening complications were recorded at 12 months, and in vivo confocal microscopy showed progressive expansion of the conjunctival cell population and formation of a clear corneal-conjunctival transition. CONCLUSIONS SCET takes advantage of the ability of the amniotic membrane and conjunctival cells to renew. Outcomes after SCET are comparable to conventional conjunctival flap surgery and can be achieved in less surgical time and with less donor tissue to be removed.
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Affiliation(s)
- Emilio Pedrotti
- Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy
| | - Marina Bertolin
- Research Unit, The Veneto Eye Bank Foundation (Fondazione Banca degli Occhi del Veneto), Pad. G. Rama, Via Paccagnella 11, 30174, Venezia, Italy
| | - Adriano Fasolo
- Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy. .,Research Unit, The Veneto Eye Bank Foundation (Fondazione Banca degli Occhi del Veneto), Pad. G. Rama, Via Paccagnella 11, 30174, Venezia, Italy.
| | - Erika Bonacci
- Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy
| | - Francesca Bosello
- Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy
| | - Diego Ponzin
- Research Unit, The Veneto Eye Bank Foundation (Fondazione Banca degli Occhi del Veneto), Pad. G. Rama, Via Paccagnella 11, 30174, Venezia, Italy
| | - Giorgio Marchini
- Ophthalmology Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, P.le L.A. Scuro 1, 37134, Verona, Verona, Italy
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Pilot study of a glue-less, suture-less amniotic membrane for pterygium excision. Int Ophthalmol 2022; 42:2933-2938. [PMID: 35364745 DOI: 10.1007/s10792-022-02281-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Pterygium is a non-cancerous, fibrovascular growth of the bulbar conjunctiva that can cause visual disturbance, ocular pain, and cosmetic concerns. Surgical management is required in certain cases, which consists of excising the pterygium and associated Tenon's, then overlaying the bare sclera with an autograft or amniotic membrane using glue or sutures. The purpose of this study is to assess outcomes of pterygium repair using a newly developed self-adhesive amniotic membrane that does not require glue or sutures for fixation. METHODS Chart review of pterygium excision using a new self-adhesive amniotic membrane from a single surgical practice from 2012-2018. Descriptive statistics from 51 primary cases of pterygium excision were included. RESULTS Pterygium recurrence occurred in 3 of the 51 self-adhesive amniotic membrane cases studied, resulting in a recurrence rate of 5.9%. Pterygium excision with the self-adhesive amniotic membrane had high rate of pyogenic granuloma formation of 27%. Self-adhesive amniotic membranes were found to perform comparably to more widely used techniques for pterygium excision, namely amniotic membranes and conjunctival autographs with glue or sutures. However, the self-adhesive grafts are associated with substantially more pyogenic granuloma formation. CONCLUSION Self-adhesive amniotic membranes offer comparable efficacy for preventing pterygium recurrence in comparison to other amniotic membranes and the conjunctival autograft. The incidence of pyogenic granuloma formation is higher in self-adhesive grafts compared to other widely used options.
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Young AL, Kam KW. Pterygium: Surgical Techniques and Choices. Asia Pac J Ophthalmol (Phila) 2019; 8:422-423. [PMID: 31789641 PMCID: PMC6903369 DOI: 10.1097/apo.0000000000000269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/03/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Alvin L. Young
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong SAR
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Ka Wai Kam
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong SAR
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR
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Validation and assessment of an antibiotic-based, aseptic decontamination manufacturing protocol for therapeutic, vacuum-dried human amniotic membrane. Sci Rep 2019; 9:12854. [PMID: 31492886 PMCID: PMC6731261 DOI: 10.1038/s41598-019-49314-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 08/16/2019] [Indexed: 02/01/2023] Open
Abstract
Amniotic membrane (AM) is used to treat a range of ophthalmic indications but must be presented in a non-contaminated state. AM from elective caesarean sections contains natural microbial contamination, requiring removal during processing protocols. The aim of this study was to assess the ability of antibiotic decontamination of AM, during processing by innovative low-temperature vacuum-drying. Bioburden of caesarean section AM was assessed, and found to be present in low levels. Subsequently, the process for producing vacuum-dried AM (VDAM) was assessed for decontamination ability, by artificially loading with Staphylococcus epidermidis at different stages of processing. The protocol was highly efficient at removing bioburden introduced at any stage of processing, with antibiotic treatment and drying the most efficacious steps. The antibacterial activity of non-antibiotic treated AM compared to VDAM was evaluated using minimum inhibitory/biocidal concentrations (MIC/MBC), and disc diffusion assays against Meticillin-resistant Staphylococcus aureus, Meticillin-resistant S. epidermidis, Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis. Antibacterial activity without antibiotic was low, confirmed by high MIC/MBC, and a no inhibition on agar lawns. However, VDAM with antibiotic demonstrated effective antibacterial capacity against all bacteria. Therefore, antibiotic decontamination is a reliable method for sterilisation of AM and the resultant antibiotic reservoir is effective against gram-positive and –negative bacteria.
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