Surgical removal of pterygium using amniotic membrane transplant mounted on freeze-dried fibrin glue – assessment of post-operative visual acuity, corneal endothelial cells density, pachymetry and recurrence

Aims of the study were to assess the corneal parameters, visual acuity, and risk of recurrence after pterygium removal procedures involving amniotic membrane attachment to the scleral bed with freeze-dried fibrin glue and – on that basis – to evaluate the safety and therapeutic efficacy of the method.

Material and methods
The study involved a total of 27 patients. The inclusion criteria were the diagnosis of primary pterygium, absence of other ophthalmic disorders, and no history of eye injuries or ophthalmic surgery. The patients’ corneal parameters (including pachymetry, corneal endothelial cell density) and visual acuity on days 7, 30 and 60 after the surgery were compared with corresponding baseline values in order to evaluate changes.

Results
Stable or improved visual acuity was demonstrated in all the subjects, with 26 patients achieving a BCVA of 1.0. The corneal endothelial cell population remained at a steady level in all the subjects, and none experienced a decline in cell density. Pachymetry showed a slight variability during the period of follow-up, with an initial upward trend up until day 30 after the surgery ultimately followed by a return closer to the baseline value on day 60 postoperatively. None of the study participants reported any pain. Two recurrences of pterygium were noted during the follow-up period of 60 days.

Conclusions
The findings of the study show that the applied technique of pterygium removal with amniotic membrane transplantation using fibrin glue is associated with a low recurrence rate (7.4%), absence of postoperative pain, stability or improvement of visual acuity, a consistent level of corneal endothelial cell population, and stable pachymetry values. Based on these outcomes, the method appears to be an effective and safe technique of pterygium removal. However, in view of the small size of the study group and the short postoperative follow-up period, further studies are needed to obtain more definite results.