Conjunctival resection with and without amniotic membrane graft for the treatment of superior limbic keratoconjunctivitis.

Abstract

PURPOSE:

To compare the efficacy of conjunctival resection versus conjunctival resection with amniotic membrane graft (AMG) in patients with superior limbic keratoconjunctivitis not responsive to medical therapies.

METHODS:

In a retrospective and comparative study, 16 eyes of 9 patients with long-lasting superior limbic keratoconjunctivitis who were refractory to medical treatment were included. Conjunctival resection was performed in 8 cases, and conjunctival resection with AMG was performed in 8 cases. Subjective symptoms, biomicroscopic signs, and impression cytology were evaluated both pre- and postoperatively.

RESULTS:

The mean follow-up period was 46 months, ranging from 1.5 to 6 years. After surgery, all cases undergoing conjunctival resection and 7 of 8 cases undergoing conjunctival resection with AMG remained asymptomatic. One case undergoing conjunctival resection with AMG experienced recurrence, requiring reoperation 2 years later (conjunctival resection without AMG). In this patient, complete disappearance of symptoms and signs was achieved during a 4-year period of follow-up after the second surgery. No intra- or postoperative complications were observed in either group. Preoperative impression cytology disclosed severe squamous metaplasia, and goblet cells were markedly decreased in all patients. Postoperative impression cytology 3 months after surgery did not show any significant improvement in squamous metaplasia in either of the groups.

CONCLUSIONS:

Conjunctival resection and conjunctival resection with AMG are effective and safe surgical procedures. Despite the potential benefits of the AMG, this procedure did not provide additional advantages in our study.

• Authors: Oscar Gris, Alicia Plazas, Enrique Lerma, José L Güell, Laura Pelegrín, Daniel Elíes
• Journal: Cornea (Cornea) Vol. 29 Issue 9 Pg. 1025-30 (Sep 2010) ISSN: 1536-4798 [Electronic] United States
• PMID: 20539210 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Amnion (transplantation)
• Combined Modality Therapy
• Conjunctiva (surgery)
• Epithelial Cells (physiology)
• Female
• Follow-Up Studies
• Humans
• Keratoconjunctivitis (diagnosis, surgery)
• Limbus Corneae
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Wound Healing