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Charles C. Farias,

Comparison Amongst Scleral, Corneal and Amniotic Membrane Grafts to Restore Scleral Thinning Secondary to Pterygium Surgery With Betatherapy. Charles C. Farias, Rossen M. Hazarbassanov, Luiz A. Vieira, Luciene B. Souza, Telma Sternlicht, Jose AP Gomes Corneal and External Disease

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Charles C. Farias,

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  1. Comparison Amongst Scleral, Corneal and Amniotic Membrane Grafts to Restore Scleral Thinning Secondary to Pterygium Surgery With Betatherapy Charles C. Farias, Rossen M. Hazarbassanov, Luiz A. Vieira, Luciene B. Souza, Telma Sternlicht, Jose AP Gomes Corneal and External Disease Departament of Ophthalmology Federal University of São Paulo - Brazil The authors have no financial interest in the subject matter of this poster P 736

  2. PURPOSE • To evaluate the use of preserved scleral, corneal and AM graft for the surgical repair of scleral thinning in patients who underwent surgery of pterygium with associated betatherapy . PARTICIPANTS • Prospective, comparative, interventional and controlled study • 28 eyes of 28 patients (one bilateral case) • The mean age was 64,5± SD (47-82) • 16 were female and 12 male • All patients were operated by one surgeon (CCF) • Surgical procedure was randomized: 1. Scleral graft (9 eyes) 2. Corneal graft (9 eyes) 3. AM graft (10 eyes)

  3. METHODS • Complete eye examination: BCVA, Biomicroscopy, Tonometry, Fundoscopy, UBM, USG • Surgical Techniques • Conjunctival peritomy, dissection and cleaning of the conjunctiva, regularity of the thinning edge with trephine, preparation of donor tissue, sclera was covered by conjunctival flap (scleral graft cases), 10-0 nylon suture • Postoperative • Topical prednisolone acetate 1% • Topical ofloxacine 0,3% • All suture were removed within 3 months • Follow up • One day, 7, 15, 30, 90 and 180 days after surgery.

  4. RESULTS • All eyes that received scleral (9/9) and corneal grafts (10/10) presented stability of the ocular surface with rapid re-epithelialization and restauration of the scleral thickness • Eyes that received the AM grafts also presented stability of the OS with re-epithelialization (10/10), but the transplanted tissue absorbed on average after 30 d of follow up (p<0.05) • 4/10 partial AM re-absortion • 6/10 total AM re-absortion

  5. Scleral – conjunctival graft group HBP- high blood pressure; DM-Diabetes Mellitus; ST- scleral thickness

  6. Corneal graft group HBP- high blood pressure ; DM-Diabetes Mellitus

  7. Amniotic membrane graft group AMT- Amniotic membrane transplantation ; DM-Diabetes Mellitus; HBP- high blood pressure

  8. Results p=0.116, one way ANOVA between the groups before and after 6 M p=0.002; Mean t test between SG pre vs 6M p<0.001; one way ANOVA with Student-Newman-Keuls test, between SG vs. CO and AM 6 M

  9. Figure 1 Scleral with calsified plaque and neovascularization Figure 2 Six months of scleral patch covered by conjunctiva

  10. Figure 3 A focal area of thinning surrounded by edematous conjuntiva Figure 4 Stability of ocular surface after six months of corneal patch

  11. Figure 5 Scleral thinning showing the uvea Figure 6 One day after amniotic membrane transplantion Figure 7 Six months of amniotic membrane transnplantation absorbed

  12. CONCLUSION Our results suggest that both scleral and corneal grafts are good options to be used for restoring scleral defects with thinning. AM is also an option to be considered for less severe cases, however it reabsorved partially or totally in most of the cases.

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