Facilitated Tenon-Free Conjunctival Autograft Preparation and Limited Tenon Removal Technique in Pterygium Surgery

Abstract

Background The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration.

Material and Methods This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017.

Results The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 – 7) minutes in group 1 and 8.23 ± 1.26 (8 – 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001).

Conclusions The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.

Zusammenfassung

Ziel Die Hauptkomplikation der primären Pterygiumchirurgie ist das Wiederauftreten des Pterygiums. In der vorliegenden Studie wollten wir die klassische Technik und die erleichterte Technik der Tenon-Kapsel-freien konjunktivalen Autograftpräparation mit der limitierten Technik der Tenon-Kapsel-Entfernung in der Pterygiumchirurgie hinsichtlich Rezidivrate, Komplikationen und Operationsdauer vergleichen.

Methoden Dies ist eine retrospektive, vergleichende Beobachtungsstudie. Gruppe 1 umfasste 120 Augen von 115 Patienten, die sich zwischen Mai 2017 und Oktober 2019 einer Pterygiumexzision mit einer neuen erleichterten Tenon-Kapsel-freien konjunktival-limbalen Autotransplantatpräparation und einer limitierten Tenon-Kapsel-Entfernungstechnik unterzogen. Gruppe 2 umfasste 117 Augen von 113 Patienten, bei denen zwischen Januar 2016 und Mai 2017 eine Pterygiumexzision mit konventioneller konjunktival-limbaler Autografttechnik durchgeführt wurde.

Ergebnisse Die mittlere Nachbeobachtungszeit nach der Operation betrug 18,2 ± 5,8 Monate in Gruppe 1 und 19,1 ± 6,3 Monate in Gruppe 2 (p = 0,25). Die mittlere Operationsdauer betrug 5,54 ± 1,22 (4 – 7) Minuten in Gruppe 1 und 8,23 ± 1,26 (8 – 10) Minuten in Gruppe 2 (p = 0,02). Ein Lappenödem war in Gruppe 2 bei 33 Augen (28,2%) und in Gruppe 1 bei 11 Augen (9,16%) vorhanden. In Gruppe 2 war das Lappenödem signifikant höher (p < 0,001). Am Ende der 1-jährigen Nachbeobachtung der Patienten beobachteten wir ein Rezidiv in nur 1 (0,83%) Auge in Gruppe 1 und 14 (11,96%) Augen in Gruppe 2. Die Rezidivrate von Gruppe 1 war signifikant geringer als die von Gruppe 2 (p < 0,001).

Schlussfolgerungen Die vereinfachte Technik der Tenon-Kapsel-freien konjunktivalen Autotransplantatpräparation und der begrenzten Entfernung der Tenon-Kapsel führte zu besseren klinischen Ergebnissen ohne schwerwiegende Komplikationen. Darüber hinaus verkürzte diese Technik die Operationszeit und reduzierte die chirurgenabhängigen Faktoren.

Key words

pterygium surgery - recurrence - tenon-free conjunctival autograft - limited tenon removal

Schlüsselwörter

Pterygiumchirurgie - Wiederauftreten - Tenon-Kapsel-freies Bindehautautotransplantat - begrenzte Entfernung der Tenon-Kapsel

Publikationsverlauf

Eingereicht: 28. Juli 2021

Angenommen: 25. August 2021

Artikel online veröffentlicht:
08. November 2021

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