Clinical Ophthalmology (Jul 2023)

Surgical Time and Postoperative Symptoms Study in Pterygium Excision and Amniotic Membrane Graft Using Celularity Triple Layer Dehydrated Amniotic Membrane

  • Rivera-Morales P,
  • Barnard L,
  • Linderman W,
  • Gill M,
  • Diaz V

Journal volume & issue
Vol. Volume 17
pp. 1967 – 1974

Abstract

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Paola Rivera-Morales, Luke Barnard, Wendy Linderman, Mohsain Gill, Vicente Diaz Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, CT, USACorrespondence: Vicente Diaz, Department of Ophthalmology, Yale School of Medicine, 40 Temple St, New Haven, CT, 06510, USA, Email [email protected]: To evaluate a novel sutureless glueless technique using a triple-layer dehydrated amniotic membrane (TLDAM) for pterygia excisions in surgical time, postoperative pain, epiphora, irritation, and FBS.Methods: Twenty eyes with pterygia underwent excision with mitomycin C. The conjunctival defect was closed with TLDAM placed on the dried scleral bed with the edges of the amniotic membrane tucked under the edges of the conjunctival defect. Surgical times were measured from injection of lidocaine to final placement of bandage contact lens. After a bandage contact lens was placed, the eye was patched until POD1. Patients graded self-administered questionnaires to rate pain, FBS, irritation, and epiphora on a scale of 1– 5 (1-none; 5-severe) at POD1 and POW1.Results: Surgical times ranged from 6:55 to 12:00, with mean of 8:29. Compared with a previous study of sutureless glueless methodology, the difference in mean surgical time was 11.9 (p < 0.0001). Mean questionnaire scores were as follows: POD1 pain 1.8, FBS 2.3, irritation 1.0, and epiphora 2.6; POW1 pain 1.5, FBS 1.6, irritation 1.6, and epiphora 1.6. Compared to previous studies, this technique showed significantly improved pain at POD1 (p=0.0086, p< 0.0001, p< 0.0001, p< 0.0001) and POW1 (p=0.0002, p=0.0016, p< 0.0001). Significant improvement in irritation and FBS was noted at POD1 and POW1. See Table 1 for full analysis.Conclusion: The sutureless glueless technique using TLDAM is a safe and effective technique compared to current standard methods. There appears to be a significant benefit regarding surgical time and postoperative pain, irritation, epiphora, and FBS compared to previous studies.Keywords: pterygium, amniotic membrane, triple layer dehydrated, sutureless, glueless

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