Simple Limbal Epithelial Transplantation (S.L.E.T.) for recurrent double-headed pterygium
What:
Paper Presentation | Présentation d'article
When:
11:18 AM, Friday 1 Jun 2018
(10 minutes)
Where:
How:
Authors: Tanguy Boutin, Zale Mednick, Allan Slomovic
Author Disclosure Block: T. boutin: None. Z. Mednick: None. A. Slomovic: Employment/honoraria/consulting fees; Name of Commercial Company(s); Alcon Canada, Bausch and Lomb Canada. Membership on an advisory panel, standing committee or board of directors; Name of Commercial Company(s); Allergan, Santen, Shire Canada, AMO.
Abstract Body:
Purpose: To show a novel surgical procedure to treat recurrent pterygium
Study Design: Case study
Methods: We present a novel case of a simple limbal epithelial transplant (SLET) performed for an aggressive recurrent kissing pterygium in a patient with history of severe atopy and chronic blepharitis. He had a previous pterygium excision done five years ago with conjunctival autograft and Mitomycin C. A healthy area of the limbus (2 clock hours) was identified and harvested in the affected eye. The double-headed kissing pterygium was excised and a superficial keratectomy was performed, followed by a 360 degree peritomy and tenotomy. Amniotic membrane was secured with fibrin glue and sutured into place with 8-0 Vicryl. The harvested limbal tissue was cut into 12 small pieces and glued onto the mid peripheral aspect of the amniotic membrane. A bandage contact lens was put into place and the patient started on a regimen of tobradex four times per day.
Results: The visual acuity improved from counting fingers at one foot to 20/60 uncorrected (pinhole 20/40) at six months. The cornea fully epithelialized and remained avascular without any signs of pterygium recurrence.
Conclusions: SLET was shown to be an effective therapeutic option for this patient with an extensive recurrent kissing pterygium. This provides promise that SLET may be a successful novel approach to other complex pterygiums, including recurrent pterygiums that have been resistant to traditional surgical techniques.
Author Disclosure Block: T. boutin: None. Z. Mednick: None. A. Slomovic: Employment/honoraria/consulting fees; Name of Commercial Company(s); Alcon Canada, Bausch and Lomb Canada. Membership on an advisory panel, standing committee or board of directors; Name of Commercial Company(s); Allergan, Santen, Shire Canada, AMO.
Abstract Body:
Purpose: To show a novel surgical procedure to treat recurrent pterygium
Study Design: Case study
Methods: We present a novel case of a simple limbal epithelial transplant (SLET) performed for an aggressive recurrent kissing pterygium in a patient with history of severe atopy and chronic blepharitis. He had a previous pterygium excision done five years ago with conjunctival autograft and Mitomycin C. A healthy area of the limbus (2 clock hours) was identified and harvested in the affected eye. The double-headed kissing pterygium was excised and a superficial keratectomy was performed, followed by a 360 degree peritomy and tenotomy. Amniotic membrane was secured with fibrin glue and sutured into place with 8-0 Vicryl. The harvested limbal tissue was cut into 12 small pieces and glued onto the mid peripheral aspect of the amniotic membrane. A bandage contact lens was put into place and the patient started on a regimen of tobradex four times per day.
Results: The visual acuity improved from counting fingers at one foot to 20/60 uncorrected (pinhole 20/40) at six months. The cornea fully epithelialized and remained avascular without any signs of pterygium recurrence.
Conclusions: SLET was shown to be an effective therapeutic option for this patient with an extensive recurrent kissing pterygium. This provides promise that SLET may be a successful novel approach to other complex pterygiums, including recurrent pterygiums that have been resistant to traditional surgical techniques.
