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eISSN: 2719-3209
ISSN: 0023-2157
Klinika Oczna / Acta Ophthalmologica Polonica
Bieżący numer Archiwum Filmy Artykuły w druku O czasopiśmie Suplementy Rada naukowa Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac Standardy etyczne i procedury
1/2021
vol. 123
 
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Operacja skrzydlika z zastosowaniem błony owodniowej i mrożonego kleju tkankowego – ocena pooperacyjnej ostrości wzroku, gęstości komórek śródbłonka rogówki, pachymetrii i ryzyka nawrotów

Maciej Kozak
1
,
Anna Wciślak
1
,
Alina Bakunowicz-Łazarczyk
2
,
Urszula Szpakowicz
1
,
Ilona Pawlicka
1

1.
Regional Ophthalmic Hospital in Krakow, Poland
2.
Pediatric Ophthalmology Department with Strabismus Treatment Center, Medical University of Bialystok Children’s Clinical Hospital of Ludwik Zamenhof, Bialystok, Poland
KLINIKA OCZNA 2021, 123, 1: 18–23
Data publikacji online: 2021/03/31
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INTRODUCTION

Pterygium refers to abnormal overgrowth of conjunctival fibrovascular tissue. It tends to grow into the cornea, impairing visual acuity by inducing astigmatism, and in severe cases, it may encroach the pupil and directly occlude the optical axis [1].
The etiology and pathogenesis of pterygium are not fully elucidated. The factors known to induce the condition include exposure to UV light, dust and dirt, as well as dry eye syndrome, and old age [1, 2].
The primary mode of management is surgery. There are many techniques to remove pterygium surgically, ranging from simple excision leaving the sclera exposed to removal followed by filling the defect with a conjunctival autograft or amniotic membrane with the use of sutures or tissue glue [3-6]. There are multiple variants of these procedures, such as P.E.R.F.E.C.T. (pterygium extended removal followed by extended conjunctival transplantation) or CLAG (conjunctival limbal autograft). In the scientific literature, there is no consensus as to which of the techniques of surgical pterygium removal is the best because some of the procedures are still associated with a high risk of recurrence. Based on the available reports, the risk of recurrence after using the technique of amniotic membrane transplantation ranges from 3.8% to 40.9% [4, 6]. On the other hand, a study conducted by Hirst demonstrates that P.E.R.F.E.C.T. is a method associated with a practically zero recurrence rate (0.01%) [7]. Other complications of the procedure include scarring and pterygium-induced astigmatism persisting after surgery.
One of the newer surgical methods involves pterygium excision followed by the placement of an amniotic membrane graft using freeze-dried fibrin glue.
Amniotic membrane has long been known and used for therapeutic purposes not only in ophthalmology but also in dermatology, plastic surgery or otolaryngology. It is harvested from the placenta during Cesarean section. To reduce the risk of transmission of infection, donor blood is always tested for infectious diseases. Since amniotic membrane is an avascular tissue and does not produce antigens of histocompatibility (HLA-A, HLA-B, HLA DR), it is well tolerated, with no rejections. The amniotic membrane transplant dissolves spontaneously, usually within 1 to 2 weeks. Based on its anti-inflammatory and anti-angiogenic properties, and the ability to accelerate epithelialization and tissue regeneration, amniotic membrane has...


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