Purpose: To determine the clinical significance of postoperative conjunctival inflammation noted at the third or fourth week after intraoperative application of mitomycin C and amniotic membrane transplantation for pterygium. Methods: This retrospective study included 27 eyes of 23 patients with primary (n = 12) or recurrent (n = 15) pterygia. All cases were operated by extensive removal of subconjunctival fibrovascular tissue and intraoperative application of 0.04% mitomycin C in the fornix, followed by amniotic membrane transplantation by using either fibrin glue (14 eyes) or sutures (13 eyes). Main outcome measures included development of conjunctival inflammation, pyogenic granuloma, and pterygium recurrence after surgery. Results: For a follow-up of 29.6 +/- 17.2 months (range, 6-56 months), 16 (59.3%) eyes without postoperative conjunctival inflammation resulted in favorable outcomes. Conjunctival inflammation around the surgical site was noted in the remaining 11 (40.7%) eyes and was significantly more common in eyes with sutures than those with fibrin glue (61.5% vs. 21.4%, respectively; P = 0.05). Among those with this inflammation, 7 eyes receiving subconjunctival injection of triamcinolone resulted in complete resolution and a good aesthetic outcome. Four eyes without this injection gradually developed conjunctival (n = 1) or corneal (n = 1) recurrence and/or pyogenic granuloma (n = 3). Conclusions: Host conjunctival inflammation is still common after intraoperative application of mitomycin C and amniotic membrane transplantation, especially when sutures are used in pterygium surgery. If left untreated, persistent inflammation may lead to a poor surgical outcome.
机构:
Univ Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
Hosp Olhos Sadalla Amin Ghanem, Joinville, SC, BrazilUniv Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
Coral-Ghanem, Ramon
Oliveira, Renan Ferreira
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Pontificia Univ Catolica Parana, Acad Curso Med, Curitiba, PR, BrazilUniv Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
Oliveira, Renan Ferreira
Furlanetto, Eduardo
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Hosp Olhos Sadalla Amin Ghanem, Joinville, SC, BrazilUniv Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
Furlanetto, Eduardo
Ghanem, Marcielle Abicalaffe
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Hosp Olhos Sadalla Amin Ghanem, Joinville, SC, BrazilUniv Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
Ghanem, Marcielle Abicalaffe
Ghanem, Vinicius Coral
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Hosp Olhos Sadalla Amin Ghanem, Joinville, SC, BrazilUniv Sao Paulo, Fac Med, Dept Oftalmol, Sao Paulo, Brazil
机构:
Department of Ophthalmology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing University
Department of Ophthalmology, Zhongda Hospital, Southeast UniversityDepartment of Ophthalmology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing University
Jing Jiang
Kai Hu
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Department of Ophthalmology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing University
Nanjing Ningyi Eye Center
Department of Ophthalmology, Zhongda Hospital, Southeast UniversityDepartment of Ophthalmology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing University