Cornea

Skip Navigation LinksHome > September 2010 - Volume 29 - Issue 9 > Conjunctival Resection With and Without Amniotic Membrane Gr...
Cornea:
doi: 10.1097/ICO.0b013e3181d1d1cc
Clinical Science

Conjunctival Resection With and Without Amniotic Membrane Graft for the Treatment of Superior Limbic Keratoconjunctivitis

Gris, Oscar MD*; Plazas, Alicia MD†; Lerma, Enrique MD‡; Güell, José L MD*; Pelegrín, Laura MD§; Elíes, Daniel MD*

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Abstract

Purpose: To compare the efficacy of conjunctival resection versus conjunctival resection with amniotic membrane graft (AMG) in patients with superior limbic keratoconjunctivitis not responsive to medical therapies.

Methods: In a retrospective and comparative study, 16 eyes of 9 patients with long-lasting superior limbic keratoconjunctivitis who were refractory to medical treatment were included. Conjunctival resection was performed in 8 cases, and conjunctival resection with AMG was performed in 8 cases. Subjective symptoms, biomicroscopic signs, and impression cytology were evaluated both pre- and postoperatively.

Results: The mean follow-up period was 46 months, ranging from 1.5 to 6 years. After surgery, all cases undergoing conjunctival resection and 7 of 8 cases undergoing conjunctival resection with AMG remained asymptomatic. One case undergoing conjunctival resection with AMG experienced recurrence, requiring reoperation 2 years later (conjunctival resection without AMG). In this patient, complete disappearance of symptoms and signs was achieved during a 4-year period of follow-up after the second surgery. No intra- or postoperative complications were observed in either group. Preoperative impression cytology disclosed severe squamous metaplasia, and goblet cells were markedly decreased in all patients. Postoperative impression cytology 3 months after surgery did not show any significant improvement in squamous metaplasia in either of the groups.

Conclusions: Conjunctival resection and conjunctival resection with AMG are effective and safe surgical procedures. Despite the potential benefits of the AMG, this procedure did not provide additional advantages in our study.

© 2010 Lippincott Williams & Wilkins, Inc.

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