Posters

Multi-recurrence pterygium with visual loss and motility limitation: surgical management

Poster Details

First Author: M. Perez Gancedo SPAIN

Co Author(s):    V. Hernandez Ortega   M. Cabezas Leon   L. Paya Serratosa              

Abstract Details

Purpose:

To show the surgical approach to deal with a recurrent nasal pterygium (5 times) that affected visual axis and caused limitation of the abduction of the left eye (OS) because of the fibrous tissue and the lack of conjunctiva.

Setting:

Cornea and Ocular Surface Unit. Ophtalmology Service. Complejo Hospitalario de Toledo. Toledo.

Methods:

Under retrobulbar anesthesia we remove the head of the pterygium. After dissection and isolation of the medial rectus, we eliminated all the fibrous tissue around it and mitomicin C 0.02 was applied 1 minute. We obtained a superotemporal conjunctival autograft, from the same eye, and placed it next to the limbus with fibrin glue. To cover the rest of the surgical bed we used half moon form amniotic membrane (AM) and fixed it with glue and reabsorbible sutures. To cover the AM and the autograft, we used a bigger patch of AM on top of them fixing it with sutures.

Results:

The patient came referred from another center for a multi-recurrence pterygium. After the surgical procedure the patient regained motility, decreased her discomfort, gained visual acuity and a good aesthetic appearance was achieved. After years of tracking there are no signs of recurrence.

Conclusions:

To remove correctly the fibrous tissue due to previous 5 surgeries, we had to isolate perfectly the muscle and a careful keratectomy had to be done to leave the corneal surface as smooth as possible to improve vision. We used conjunctiva and AM to reconstruct the surgical bed, placing the conjunctival autograft next to the limbus, exactly where the pterygium was, and AM to complete the lack of healthy conjunctiva.

Financial Disclosure:

NONE