Mitomycin C, amniotic membrane transplantation and limbal conjunctival autograft for treating multirecurrent pterygia with symblepharon and motility restriction.
BACKGROUND
Treatment of eyes with multirecurrent pterygia associated with severe symblepharon and motility restriction is challenging. A combined surgical procedure of intraoperative mitomycin C, amniotic membrane transplantation and conjunctival limbal autograft was applied for treating such eyes.


METHODS
Seven eyes of seven patients who had previously undergone an average of four operations for pterygial removal and who manifested recurrent pterygia associated with severe symblepharon and motility restriction were involved in this retrospective study. The surgical procedures involved clearing fibrovascular membrane over the cornea, extensive excision of epibulbar fibrovascular tissue to the bare sclera, application of 0.02% mytomycin C onto the bare sclera for 5 min and transplantation of preserved human amniotic membrane and conjunctival limbal autograft.


RESULTS
Postoperatively, all seven eyes showed rapid epithelialization on the corneal surface in 3-5 days and, on the conjunctival surface, in 10-18 days. For a mean follow-up period of 22.4+/-6.1 months, six eyes recovered deep fornices, smooth and stable ocular surface and full ocular motility without recurrence. One eye showed regrowth of fibrovascular tissue and motility restriction but less severe than before surgery. No complication was noted due to mitomycin C.


CONCLUSIONS
Combined intraoperative mitomycin C, amniotic membrane graft and limbal conjunctival autograft are successful approaches for treating multirecurrent pterygia with severe symblepharon to restore the ocular surface integrity and prevent recurrence.
Yao
Yu-Feng
YF
Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qinchun Road East, Hangzhou, 310016, Zhejiang, People's Republic of China. yaoyuf@mail.hz.zj.cn
Qiu
Wen-Ya
WY
Zhang
Yong-Ming
YM
Tseng
Scheffer C G
SC
D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D000650:Amnion / Q000637:transplantation*; D017690:Cell Transplantation; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000637:transplantation*; D003229:Conjunctival Diseases / Q000209:etiology / Q000628:therapy*; D005141:Eyelid Diseases / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D015835:Ocular Motility Disorders / Q000209:etiology / Q000628:therapy*; D011625:Pterygium / Q000150:complications / Q000628:therapy*; D012008:Recurrence; D012590:Sclera / Q000187:drug effects; D000267:Tissue Adhesions / Q000209:etiology / Q000628:therapy; D014182:Transplantation, Autologous
D000477:Alkylating Agents; D016685:Mitomycin