Autologous cultivated conjunctival transplantation for pterygium surgery.
OBJECTIVE
To investigate the safety and efficacy of autologous cultivated conjunctival transplantation for the treatment of primary pterygium.


METHODS
Prospective nonrandomized clinical trial.


METHODS
Forty patients with primary pterygium were recruited. Excision of the pterygium was followed by reconstruction using a serum-free derived autologous cultivated conjunctival equivalent in 22 patients (group A) and conventional denuded amniotic membrane transplantation in 18 patients (group B). In group A patients, conjunctival epithelial equivalents were constructed by the ex vivo expansion of conjunctival epithelial cells on human amniotic membranes (HAM). The main outcome measures were conjunctival epithelialization, recurrence, survival analysis, and incidence of complications.


RESULTS
The mean follow-up was 14.1 +/- 3.9 months (range, 12 to 25 months). Complete epithelialization was achieved within five days after surgery in group A patients compared with approximately three weeks for group B patients. The proportion of patients that had true recurrences was 22.7% in group A and 25.0% in group B. The mean time to recurrence was 4.8 +/- 1.6 months in group A and 5.0 +/- 2.9 months in group B. No ocular complications were noted in group A, while one eye (6.0%) in group B developed scleral necrosis associated with a persistent epithelial defect.


CONCLUSIONS
Transplantation of an autologous cultivated conjunctival epithelial sheet facilitated early postoperative epithelialization and recovery, and may aid in preventing serious complications associated with simple denuded HAM transplantation, such as scleral necrosis and secondary infection. This may provide a novel method for conjunctival epithelial replacement in the treatment of ocular surface disorders.
Ang
Leonard P K
LP
Singapore National Eye Center, Singapore.
Tan
Donald T H
DT
Cajucom-Uy
Howard
H
Beuerman
Roger W
RW
D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation; D017690:Cell Transplantation; D002478:Cells, Cultured; D018920:Coculture Techniques; D003228:Conjunctiva / Q000166:cytology / Q000637:transplantation*; D004847:Epithelial Cells / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011625:Pterygium / Q000601:surgery*; D012449:Safety; D014182:Transplantation, Autologous; D016896:Treatment Outcome