ACTA 0 zyxwvut LKJIHGF P H T H A zyxwvutsrqp L M 0 LOG I C A 72 (1994) 721-726 Limbal-conjunctival autograft transplantation in cases with recurrent pterygium Murat Guler, Gungor Sobaci, Sami Ilker, Faruk Ozturk, F. Mehmet Mutlu and Erol Yildirim Department of Ophthalmology, GATA Military Academy of Medicine, Etlik-Ankara, Turkiye Abstract. This prospective study was undertaken to evaluate limbal conjunctival autotransplantation in the management of cases with recurrent pterygium. At pres- ent, new surgical techniques to prevent pterygium recur- rence following surgery are in investigation. In recent years, it has been postulated that pterygium is due to hy- pofunction of lbnbal stem cells. Thirty-one out of 49 pa- tients with recurrent pterygium were treated by limbal- conjunctival autograft transplantation and the other 18 treated by Czermak technique, including two line of lim- bal cauterization intraoperatively, and used as a control group. During a mean follow-up period of 10 months zyxwv CBA (ranging 3-18 months), 4 recurrences zyxwvu JIHGFE (13.3Yo) in the lim- bal-conjunctival autograft transplantation group and 9 recurrences zyxwvut IHGFEDC (50%) in the control group were observed. We conclud that this was a successful method to prevent secondary recurrence in the management of recurrent pterygium patients under 40 years of age. Key words: Czermak technique - limbal-conjunctival auto- graft transplantation - recurrent pterygium. Pterygium, a fibrovascular overgrowth of bulbar conjunctiva over cornea, is a well-known disease of the ocular surface. The most effective therapy for pterygium is surgery. Although many surgical techniques and adjunctive therapies have been proposed, recurrence is frequent complication, reaching as high as 88% (Zauberman 1967). When surgical techniques proposed for primary pterygium have been applied in recurrent cases, the possibility of secondary recurrence has been shown to increase (Tseng et al. 1990). New thera- peutic strategies should be searched for because of the complications of surgical procedures and the high recurrence rate after treatment of this dis- ease. Recently, as a result of studies on stem cells that lie at the basal layer of limbic epithelium, con tival autografts with limbic epithelium have b suggested in management of pterygium. In this study, the effectiveness of limbal-con junctivalautograft transplantation technique (LCAT) to prevent secondary recurrence in management of cases with recurrent pteryg has been studied prospectively. Materials and Methods From November 1990 to July 1992,49 patient recurrent pterygium who were admitted to Clinic of Giilhane Military Academy of Medic were included in this study. zyx IHG All patients had a re- currence, but one had pterygium with second recurrence. The criteria for eligibility: 1) At least 6 months should have passed afte the last operation. 2) Pterygium growth over the cornea of mor than 3 mm. 3) No other ocular surface pathology presen 4) Any infection on the ocular surface or a sys- temic pathology which might be a contraindic tion for ocular surgery. 5) Complaints despite topical treatment wit dexamethazon sulphate eye drops and a lubri ing agent polyvinylalcohol (Protogent") q.i.d. 15 days. 721