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Klin Monbl Augenheilkd 2024; 241(07): 819-827
DOI: 10.1055/a-1648-4753
Klinische Studie

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

Erleichterte Tenon-Kapsel-freie konjunktivale Autograftvorbereitung und begrenzte Tenon-Kapsel-Entfernungstechnik in der Pterygiumchirurgie
Fikret Ucar 
1   Ophthalmology, Private Konyagoz Hospital, Konya, Turkey
,
Lutfi Seyrek
1   Ophthalmology, Private Konyagoz Hospital, Konya, Turkey
,
Servet Cetinkaya
1   Ophthalmology, Private Konyagoz Hospital, Konya, Turkey
,
Huseyin Ture
2   Ophthalmology, Karaman Selcuklu Hospital, Karaman, Turkey
,
Ekrem Kadioglu
1   Ophthalmology, Private Konyagoz Hospital, Konya, Turkey
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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

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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