Dehydrated human-amnioticmembrane allograft versus conjunctival autograft after pterygium excision
Kristine T. Lo, MD, Ruben Lim-Bon-Siong, MD
Objective
To compare the efficacy of dehydrated human-amniotic-membrane allograft
with conjunctival autograft attached with fibrin glue following pterygium
excision.
Methods
Forty-two patients undergoing excision of primary pterygium were enrolled
in this prospective, randomized, interventional, controlled trial. After excision
of pterygium, a superior bulbar conjunctival autograft was harvested and
transferred onto bare sclera in 21 eyes, and dehydrated human-amnioticmembrane allograft (AmbioDry) in 21 eyes. Fibrin glue (Beriplast P) was used
to attach the grafts in both groups. The patients were followed up for 3 months.
Results
All grafts in both groups were successfully attached. One patient in the
conjunctival autograft group experienced graft dehiscence. Mean surgery time,
postoperative pain, foreign-body sensation, and discomfort were not statistically
different (p = 0.16, p = 0.07, p = 0.82, and p = 0.31 respectively). No recurrence
was noted within the observation period. At day 1 postoperatively, mean tearingseverity scores of patients that received dehydrated amniotic-membrane
allograft were statistically lower than those that received conjunctival autograft
(p = 0.024). Cosmetic-grading results were statistically higher in the conjunctival
autograft group at 3 months postoperatively (p = 0.003).
Conclusion
Dehydrated human-amniotic-membrane allograft attached with fibrin glue
and anchored with nylon sutures is a safe and effective adjunct after excision
of primary pterygium. It is comparable to conjunctival autograft in preventing
early recurrence and can be considered as a primary grafting method after
primary pterygium excision. However, conjunctival autograft has better
cosmetic results than amniotic-membrane allograft.
Keywords: Pterygium, Conjunctival autograft, Amniotic-membrane transplantation, Fibrin glue