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ORIGINAL ARTICLE
Year : 2011  |  Volume : 4  |  Issue : 3  |  Page : 120-124

Separate limbal-conjunctival autograft transplantation using the inferior conjunctiva for primary pterygium


1 Department of Ophthalmology, Kagoshima University Faculty of Medicine, Kagoshima;Kawano Eye Centre, Satsumasendai, Kagoshima, Japan
2 Kawano Eye Centre, Satsumasendai, Kagoshima, Japan
3 Department of Ophthalmology, Kagoshima University Faculty of Medicine, Kagoshima, Japan

Correspondence Address:
Taiji Sakamoto
Department of Ophthalmology, Kagoshima University Faculty of Medical and Dental Sciences. 8-35-1 Sakuragaoka, Kagoshima 890-8520
Japan
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Source of Support: Health and Labor Sciences Research Grants from the Ministry of Health, Labor and Welfare of Japan, Tokyo, Japan; the Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan, Conflict of Interest: None


DOI: 10.4103/0974-620X.91267

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Background : Inferior limbal-conjunctival autograft transplantation has been described as a safe and effective treatment for primary pterygium. However, despite its multiple advantages, routine performance of this technique is difficult because the inferior conjunctiva is often too small to provide enough autograft material. To resolve this issue, we modified a technique, inferior separate limbal-conjunctival autograft transplantation, and evaluated its efficacy and safety Materials and Methods : A total of 50 eyes of 47 patients were retrospectively studied. Our surgery consisted of a thorough pterygium excision followed by 0.02% mitomycin C application. Next, we performed inferior conjunctival autografting, in which limbal and bulbar conjunctival autografts were independently harvested and secured to the denuded limbus and the most posterior conjunctival defect at the pterygium excision site to ensure stem-cell restoration and deep fornix reconstruction, respectively; the bare sclera between the two grafts was exposed. The outcome was assessed with a three-point grading scale at the patient's last visit. Results : The success and recurrence rates were 96.0% (48 of 50) and 0%, respectively, assessed at follow-ups occurring at a mean of 19.2 ΁ 5.6 months after surgery. Only minimal complications were encountered. Conclusion : A combination of inferior separate limbal-conjunctival autograft transplantation with intraoperative 0.02% mitomycin C application is a safe and effective technique enabling the routine use of under-sized autografts harvested from the inferior conjunctiva after thorough pterygium excision.


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