The Effect Of Micro-conjunctival Autografting Combined With Amniotic Membrane Transplantation On Treating Recurrent Pterygium

Aims: To observe the effect of micro-conjunctival autografting combined with amniotic membrane transplantation on the ocular surface recovery,the postoperative recurrence,ocular surface and dry eye related symptoms among patients with recurrent pterygium.Methods: A non-randomized controlled trial including 40 patients(43 eyes)with recurrent pterygium.The experimental group(n?=?20,21 eyes)received micro-conjunctival autograft(2.0mm×3.0mm)combined with amniotic membrane transplantation while the control group(n?=?20,22 eyes)was given conventional autologous conjunctival transplantation(depending on the area of the exposed sclera after the pterygium been removed).Except for postoperative recurrence,complications and pterygium size,ocular surface symptoms measured with Schirmer test Ⅰ,partial ocular surface symptom score.Data were analyzed by SPSS version25.0.Results: At 6 months after surgery,there were no recurrences of recurrent pterygium treated with micro-conjunctival autografting combined with amniotic membrane transplantation and conventional autologous conjunctival transplantation,and there was no statistically significant difference in the grade of conjunctival hyperplasia between the two groups(P>0.05).The corneal epithelium healed 3 to 5days after surgery,and there was no difference between the groups(P>0.05).All patients showed a slight improvement in visual acuity with a smooth intraocular pressure after operation,which didn’t differ between groups(P > 0.05).Patients in the experimental group achieved a significant increase in foreign body sensation in 3and 7 days after surgery(p?<?0.05)than the control group,and thereafter,there was no statistical difference between the two groups(P>0.05).At 3,7,14,30,and 90 days after operation,there was no difference in dryness between the two groups(P>0.05),whereas at 6 months postoperatively,the dryness scores of the control group were higher than that of the experimental group(P<0.05).There was a decrease in Schirmer test Ⅰ,burning sensation and pain,without statistical significance across different time point measurements at p?<?0.05 between the groups.During the observational period,there was no other serious complications.Conclusions: There is no difference in the recurrence rate between micro-conjunctival autografting combined with amniotic membrane transplantation and conventional autologous conjunctival transplantation,and the ocular surface injury is relatively small.For patients with recurrent pterygium who have conjunctival preservation needs such as conjunctival deficiency or combined with dry eye disease and the risk of angle closure,it can be used as the optimal surgical plan.