Publication: Primer pterjiumun cerrahi tedavisinde Mitomisin-C ile birlikte çift katlı titanyum-trombositten zengin fibrin membran otogrefti uygulamasının etkinliğinin değerlendirilmesi. / To investigate the efficacy of double layer titanium-platelet rich fibrin (T-PRF) membrane autograft with application of Mitomycin-C (MMC) in surgical treatment of primary pterygium.
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Date
2020
Authors
Authors
BABAYEV, Rumil
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Bezmialem Vakıf University
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Abstract
Introduction: To investigate the efficacy of double layer titanium-platelet rich fibrin (T-PRF) membrane autograft with application of mitomycin-C (MMC) in surgical treatment of primary pterygium. Materials and methods: This study included medical records of 116 eyes from 104 patients who were underwent surgery for primary pterygium between January 2016 and July 2019 in our center. The cases were divided into 3 groups according to the surgical techniques; group 1 (LCA) cases was operated by limbal conjunctival autograft technique, group 2 (T-PRF) by single-layer T-PRF technique and group 3 (MMC+T-PRF) by double-layer T-PRF with application of MMC. The patients' own blood was collected and centrifuged in titanium tubes and mechanically compressed to prepare T-PRF membranes. Demographic information and preoperative ocular findings of patients, eye examination findings in follow-up, recurrence and complications were analyzed. Results: The mean follow-up period was 16.38±10.26 months (range, 3-36 months). The mean size of pterygium was 2.49±0.83 mm (1.1-5.0 mm). 113 (97.4%) were nasally and 3 (2.6%) were temporally located. The mean age of patients at the time of surgery was 51.16 ± 14.61 years (range, 20-86 years). Recurrence was observed in 32 (27.6%) of all cases. The median time to recurrence was 5.20 ± 2.09 months. No surgical complications were observed in our cases. In 1 (1,6%) of the cases (n=61) in LCA group was found aponeurotic ptosis in the 1st week. In 1 (3.3%) of the cases in T-PRF group (n = 30) was found bare sclera due to loss of graft, and in 1 (3.3%) conjunctival granuloma. In MMC + T-PRF group, no complications were detected during postoperative follow-up. According to the surgical techniques, a statistically significant difference was found between the recurrence rates of the groups (p = 0.023; p <0.05). The recurrence rate of T-PRF group was 46.7%, LKO group was 19.7%, MMC + T-PRF group was 24.0%. There was no statistically significant difference between MMC + T-PRF group and LKO recurrence rates (p> 0.05). Conclusion: T-PRF membrane autograft has advantages such as easy preparation, shortening the surgical time, low cost and making it in required size. The success rate of MMC + T-PRF technique was similar to that of limbal conjunctival and conjunctival techniques. This technique may be an alternative method in patients who are not eligible for conjunctival or limbal conjunctival autograft techniques in pterygium surgery. In order to be accepted as the standard method, it is necessary to carry out new studies with more cases and longer period of follow-up, also the surgical technique of MMC + T-PRF needs to be improved. Key words: autograft, pterygium surgery, titanium-platelet rich fibrin membrane (T-PRF), mitomycin-C (MMC).
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Description
Thesis (Medical)--Bezmialem Vakıf University, Faculty of Medicine, Department of Eye Diseases, Istanbul, 2020
Keywords
Göz Hastalıkları = Eye Diseases