Hybrid technique for pterygium surgery shows promise

The authors describe a novel combination technique for pterygium excision that may be a better option in patients with limited amounts of conjunctiva.

The minor ipsilateral simple limbal epithelial transplantation (mini-SLET) technique described is a hybrid between a conjunctival autograft and amniotic membrane graft. Following excision of the pterygium, amniotic membrane is used to cover the bare sclera. A small 2x2mm piece of limbal epithelium is harvested from the same eye and cut into 8 to 10 pieces. The pieces and distributed in a linear fashion along the conjunctival side of the limbus over the previously fixed amniotic membrane and glued into place with fibrin glue. The entire area is covered with a second amniotic membrane.

Ten eyes underwent the procedure. At 8 months follow-up, there were no signs of early recurrence or sight-threatening complications.

While previous studies show conjunctival autograft has the lowest rate of recurrence, it cannot be performed in patients with large defect areas or in cases in which the conjunctiva needs to be preserved for future glaucoma surgery.

The primary benefit of the mini-SLET technique is conservation of host tissue as only a small section of limbal tissue is required, leaving behind healthy conjunctiva if another procedure is required. While the surgery may be more time-consuming than a traditional conjunctival autograft, this technique is easy to learn and it offers a useful alternative in cases of pre-existing conjunctival scarring, in post- glaucoma surgery patients or when another surgery is anticipated.