title: [Outcome of conjunctival autograft with amniotic membrane transplantation for recurrent pterygium].
abstract: OBJECTIVE
  To investigate the outcome of conjunctival autograft with amniotic membrane transplantation without the use of mitomycin C for cases of recurrent pterygium.
  
  
  METHODS
  Thirty-nine eyes of 35 patients (aged 27 to 76 years) who underwent the surgical procedure for recurrent pterygium at Yamaguchi University Hospital from November 1998 to July 2007 were evaluated retrospectively from their medical records. Patients who did not undergo postoperative follow-up examination for at least 6 months were excluded. The mean number of prior surgeries was 2.9 (range, 2 to 10), and the mean +/- SD follow-up time was 42.0 +/- 29.6 months.
  
  
  RESULTS
  Twenty seven of 29 eyes (93.1%) with recurrent grade 3 pterygium showed a reduction in the size of the new growth after surgery. The symblepharon improved postoperatively in 5 of 15 eyes (33.3%) and restriction of ocular movement improved in 11 of 24 eyes (45.8%). Most recurrences occurred within 6 months after surgery, although one case did not show a recurrence until 2 years postsurgery.
  
  
  CONCLUSIONS
  Conjunctival autograft with amniotic membrane transplantation without the use of mitomycin C reduced the size of the recurrent pterygium. However, 6 of the 16 eyes (37.5%) required subsequent surgery, suggesting that the procedure has limitations. Mitomycin C should therefore possibly be considered for cases with severe symblepharon or restriction of ocular movement. In choosing the surgical procedure for recurrent pterygium, diplopia can be an important indicator of the severity of a symblepharon or restriction of ocular movement.
authors: Tokuyama Central Hospital, Japan.
authors: Atsuko
authors: A
authors: Tanaka
authors: Tai-ichiro
authors: T
authors: Chikama
authors: Daisuke
authors: D
authors: Harada
authors: Koji
authors: K
authors: Kawamoto
authors: Naoyuki
authors: N
authors: Yamada
authors: Naoyuki
authors: N
authors: Morishige
authors: Teruo
authors: T
authors: Nishida