Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium

We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A tot...

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Main Authors: Alok Sati, Sanjay Kumar Mishra, Sarvadarshi Shukla, Deepesh Unni, Sonali V. Kumar, Sanjay Kumar Dhar, Jaya Kaushik, Vijay Kumar Sharma, Anju Pannu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-06-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/IJO.IJO_1413_24
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author Alok Sati
Sanjay Kumar Mishra
Sarvadarshi Shukla
Deepesh Unni
Sonali V. Kumar
Sanjay Kumar Dhar
Jaya Kaushik
Vijay Kumar Sharma
Anju Pannu
author_facet Alok Sati
Sanjay Kumar Mishra
Sarvadarshi Shukla
Deepesh Unni
Sonali V. Kumar
Sanjay Kumar Dhar
Jaya Kaushik
Vijay Kumar Sharma
Anju Pannu
author_sort Alok Sati
collection DOAJ
description We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e., pterygium extended removal (PER) (removal of tenon capsule with fibrovascular tissue around medial rectus from limbus till medial canthus) followed by minor ipsilateral limbal epithelial transplantation (coverage of bare sclera with amniotic membrane graft and placement of ipsilateral limbal pieces at the affected limbus). The patients were reviewed on day 1, day 7, and day 30 and at third, sixth, and twelfth month after surgery, and none of the eyes (0/9) showed recurrence of pterygium on to the cornea. Time taken for surgery was 53.88 ± 8.74 minutes (range, 45 to 75 minutes). Postoperative discomfort (pain, irritation, foreign body sensation, and lacrimation) persisted mainly for day 1 after the surgery. However, lacrimation persisted till day 7 in two of the patients. Intraoperative complications were seen in none of the eyes. A total of 1/9 patients had granuloma formation, and 1/9 had dellen formation in postoperative period with successful management. Moreover, none of the eyes (0/9) developed ocular motility restrictions in postoperative period. PERMISLET, an innovative surgical technique for recurrent pterygium, is a viable option with zero rate of recurrence and minimal complications, a boon for patients with limited healthy conjunctiva or a potential for future glaucoma drainage procedures.
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1998-3689
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spelling doaj-art-bb06cdc7c07c432ea28d20b74dfc04c12025-08-20T03:31:24ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-06-0173Suppl 3S517S52310.4103/IJO.IJO_1413_24Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygiumAlok SatiSanjay Kumar MishraSarvadarshi ShuklaDeepesh UnniSonali V. KumarSanjay Kumar DharJaya KaushikVijay Kumar SharmaAnju PannuWe describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e., pterygium extended removal (PER) (removal of tenon capsule with fibrovascular tissue around medial rectus from limbus till medial canthus) followed by minor ipsilateral limbal epithelial transplantation (coverage of bare sclera with amniotic membrane graft and placement of ipsilateral limbal pieces at the affected limbus). The patients were reviewed on day 1, day 7, and day 30 and at third, sixth, and twelfth month after surgery, and none of the eyes (0/9) showed recurrence of pterygium on to the cornea. Time taken for surgery was 53.88 ± 8.74 minutes (range, 45 to 75 minutes). Postoperative discomfort (pain, irritation, foreign body sensation, and lacrimation) persisted mainly for day 1 after the surgery. However, lacrimation persisted till day 7 in two of the patients. Intraoperative complications were seen in none of the eyes. A total of 1/9 patients had granuloma formation, and 1/9 had dellen formation in postoperative period with successful management. Moreover, none of the eyes (0/9) developed ocular motility restrictions in postoperative period. PERMISLET, an innovative surgical technique for recurrent pterygium, is a viable option with zero rate of recurrence and minimal complications, a boon for patients with limited healthy conjunctiva or a potential for future glaucoma drainage procedures.https://journals.lww.com/10.4103/IJO.IJO_1413_24extended tenonectomyminor ipsilateral limbal epithelial transplantationrecurrent pterygium
spellingShingle Alok Sati
Sanjay Kumar Mishra
Sarvadarshi Shukla
Deepesh Unni
Sonali V. Kumar
Sanjay Kumar Dhar
Jaya Kaushik
Vijay Kumar Sharma
Anju Pannu
Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
Indian Journal of Ophthalmology
extended tenonectomy
minor ipsilateral limbal epithelial transplantation
recurrent pterygium
title Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
title_full Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
title_fullStr Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
title_full_unstemmed Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
title_short Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium
title_sort pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation permislet an innovative technique for recurrent pterygium
topic extended tenonectomy
minor ipsilateral limbal epithelial transplantation
recurrent pterygium
url https://journals.lww.com/10.4103/IJO.IJO_1413_24
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