Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study)
Purpose: To compare the conjunctival epithelial morphology after two types of pterygium excision procedures. Materials and Methods: Twenty-seven eyes of 22 patients with primary pterygium were randomly assigned to bare-sclera with intra-operative mitomycin C (MMC 0.02% for 60 seconds; group I) and p...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Journal of Clinical Ophthalmology and Research |
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| Online Access: | http://www.jcor.in/article.asp?issn=2320-3897;year=2013;volume=1;issue=2;spage=87;epage=90;aulast=Bhatnagar |
| _version_ | 1818236308181483520 |
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| author | Kavita R Bhatnagar M N Karandikar Deepa Mujumdar Varsha Kulkarni |
| author_facet | Kavita R Bhatnagar M N Karandikar Deepa Mujumdar Varsha Kulkarni |
| author_sort | Kavita R Bhatnagar |
| collection | DOAJ |
| description | Purpose: To compare the conjunctival epithelial morphology after two types of pterygium excision procedures. Materials and Methods: Twenty-seven eyes of 22 patients with primary pterygium were randomly assigned to bare-sclera with intra-operative mitomycin C (MMC 0.02% for 60 seconds; group I) and pterygium excision with conjunctival autografting (group II). Controls were healthy eyes of age- and sex-matched subjects. Impression cytology was performed preoperatively, and at 2 weeks, 1, 3, 6, and 12 months after surgery. At each visit, any recurrence or complications were looked for. Result: There was no recurrence with conjunctiva lautograft. Though one eye had recurrence in MMC group, none showed any serious complications like corneal or scleral melting, glaucoma, or cataract. Pterygium excision wounds healed in a similar four-stage process in both the groups, but at different rates and with different final results. The nucleus-to-cytoplasm (N/C) ratio was highest at about 1 month postoperatively in group 1 and at 2 weeks in group 2, before gradually returning to control levels. Preoperatively, the goblet cell density (GCD) in treated eyes was almost twice than that in control eyes (P = 0.001), but fell to zero immediately postoperatively. Goblet cells first appeared (with rapidly increased density) in group II. At 12 months, the mean GCD in group II was not significantly different from those in controls, whereas the mean GCD in group I was still less than that of control (p = 0.02). Conclusion: A single application of mitomycin c after pterygium excision in the concentration of 0.02% for duration of 60 seconds is not associated with serious complications. Conjunctival autograft prevents corneal recurrence more effectively than MMC. Goblet cell density is markedly reduced by mitomycin c. Even 1 year after surgery, the ocular surface remains abnormal with respect to epithelial phenotypes in eyes treated by any of the two techniques. |
| first_indexed | 2024-12-12T12:07:48Z |
| format | Article |
| id | doaj.art-ecc679fd60764a7dbee3216ed1ae81cf |
| institution | Directory Open Access Journal |
| issn | 2320-3897 |
| language | English |
| last_indexed | 2024-12-12T12:07:48Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Clinical Ophthalmology and Research |
| spelling | doaj.art-ecc679fd60764a7dbee3216ed1ae81cf2022-12-22T00:24:58ZengWolters Kluwer Medknow PublicationsJournal of Clinical Ophthalmology and Research2320-38972013-01-0112879010.4103/2320-3897.112176Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study)Kavita R BhatnagarM N KarandikarDeepa MujumdarVarsha KulkarniPurpose: To compare the conjunctival epithelial morphology after two types of pterygium excision procedures. Materials and Methods: Twenty-seven eyes of 22 patients with primary pterygium were randomly assigned to bare-sclera with intra-operative mitomycin C (MMC 0.02% for 60 seconds; group I) and pterygium excision with conjunctival autografting (group II). Controls were healthy eyes of age- and sex-matched subjects. Impression cytology was performed preoperatively, and at 2 weeks, 1, 3, 6, and 12 months after surgery. At each visit, any recurrence or complications were looked for. Result: There was no recurrence with conjunctiva lautograft. Though one eye had recurrence in MMC group, none showed any serious complications like corneal or scleral melting, glaucoma, or cataract. Pterygium excision wounds healed in a similar four-stage process in both the groups, but at different rates and with different final results. The nucleus-to-cytoplasm (N/C) ratio was highest at about 1 month postoperatively in group 1 and at 2 weeks in group 2, before gradually returning to control levels. Preoperatively, the goblet cell density (GCD) in treated eyes was almost twice than that in control eyes (P = 0.001), but fell to zero immediately postoperatively. Goblet cells first appeared (with rapidly increased density) in group II. At 12 months, the mean GCD in group II was not significantly different from those in controls, whereas the mean GCD in group I was still less than that of control (p = 0.02). Conclusion: A single application of mitomycin c after pterygium excision in the concentration of 0.02% for duration of 60 seconds is not associated with serious complications. Conjunctival autograft prevents corneal recurrence more effectively than MMC. Goblet cell density is markedly reduced by mitomycin c. Even 1 year after surgery, the ocular surface remains abnormal with respect to epithelial phenotypes in eyes treated by any of the two techniques.http://www.jcor.in/article.asp?issn=2320-3897;year=2013;volume=1;issue=2;spage=87;epage=90;aulast=BhatnagarConjunctival epithelial morphologyimpression cytologypterygium excision |
| spellingShingle | Kavita R Bhatnagar M N Karandikar Deepa Mujumdar Varsha Kulkarni Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) Journal of Clinical Ophthalmology and Research Conjunctival epithelial morphology impression cytology pterygium excision |
| title | Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) |
| title_full | Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) |
| title_fullStr | Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) |
| title_full_unstemmed | Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) |
| title_short | Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study) |
| title_sort | impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin c and conjunctival autograft limbal autograft a pilot study |
| topic | Conjunctival epithelial morphology impression cytology pterygium excision |
| url | http://www.jcor.in/article.asp?issn=2320-3897;year=2013;volume=1;issue=2;spage=87;epage=90;aulast=Bhatnagar |
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