LIMBAL ALLOTRANSPLANTATION IN COMBINATION WITH AUTOCONJUNCTIVOPLASTY - A METHOD OF CHOICE IN TREATMENT OF RECURRENT PTERYGIUM
Despite the number of new methods of treatment and surgery developed for recurrent pterygium, the surgeon still does not have confidence that this pterygium no longer recurs. Achieving a stable postoperative result with this pathology remains an unresolved problem. The dissatisfaction with the achieved percentage of stable remission led to the creation of a new, more effective method, which consists in combining two most perspective methods - autoconjunctivoplasty and limbal allograft. We also used fragments of a decellularized donor sclera with multipоtent mesenchymal stromal cells (MMSCs) cultured on it as limbal allografts. According to the technique described by us, 10 operations were performed. Despite the previously repeated relapses in all patients who underwent surgery according to the proposed technique, no undesirable effects were observed at follow-up period of 1-2 years. Complete epithelization of the excised pterygium zone in the corneal projection was achieved the day after surgery. The sutures were removed 10-14 days after the operation. The combination of 2 most promising methods of autoconjunctivoplasty and transplantation of the limb fragments preserved in normothermia or decellularized sclera with MMSC cultured on it led to the creation of a new method of surgical treatment of pterygium, which minimizes the likelihood of relapse. Using a wide range of MMSC therapeutic potential in transplants allows to create a local source of anti-inflammatory, regenerative cytokines, provides local immunosuppression, inhibits the growth of vascular tissue, accelerates the corneal epithelization and allows the regeneration process to start instead of repairing the zone of local limbal insufficiency.