Recent findings from a seven-year study offer promising insight into the use of the TissueTuck sutureless technique with BioTissue AmnioGraft cryopreserved amniotic membrane (CAM) during pterygium excision surgery
Let’s start with this company.
A biotechnology company, BioTissue is the developer of products derived from cryopreserved human amniotic and umbilical cord tissues.
Its portfolio of CAM products feature the CryoTek, its proprietary cryopreservation technology, designed to maintain the tissue’s structural and functional integrity.
To note, these products are currently the only amniotic grafts that are FDA cleared for their therapeutic properties in repairing and healing ocular surface inflammation, according to the company.
Now pterygium.
A pterygium is an ocular surface disease that manifests as an elevated, wedged-shaped sectoral area that begins as a growth of the conjunctiva and tends to migrate onto the cornea.
Pterygia can permanently alter the ocular surface shape,cause blurry vision and discomfort, and potentially lead to vision loss.
And pterygium surgery?
During the autograft method of pterygium surgery, a surgeon places a small portion of the patient’s conjunctiva into the surgical site.
From there, absorbable sutures or tissue adhesive is then used to seal the wounds.
What are the cons?
The cons to this surgery are that additional inflammation, scarring, discomfort, and a possible lengthy patient recovery time can ensue due to relocating the patient’s conjunctiva and creating two surgical wounds.
Explain this TissueTuck technique.
Developed by Neel R. Desai, MD, the technique seals the gap that is created between the remaining conjunctiva and Tenon’s capsule, where the surgeon then places CAM (BioTissue AmnioGraft) into the gap to prevent future occurrences—without potential complications.
Go on …..
The TissueTuck technique is intended to overcome the drawbacks of conventional pterygium surgery’s autograft method by addressing four key criteria:
- Minimizing surgical trauma
- Reducing post-op inflammation
- Enhanced sealing of the gap where pterygium and where any recurrence might stem from
- Reconstructing the fold to stop future problems: pigmented skin growths, scar tissue, muscle restriction, blurry vision, and pterygium recurrence
And the advantages?
Per Dr. Desai, the technique is intended to take an average of less than 15 minutes— “which is significantly shorter than the 30 to 60 minutes in procedures that use conjunctival autografts,” he stated in a news release.
He added that it is also designed to preserve the conjunctiva in the oft chance of future glaucoma surgery.
Now talk about this study.
The single-center, retrospective study reviewed 453 patients (582 eyes; 382 females; 65.1 ± 13.9 years) with primary (92%) or recurrent pterygium who underwent surgical excision followed by CAM via TissueTuck.
All procedures took place between January 2012 and May 2019.
What was measured?
Four key areas:
- Patient profile
- Surgical time
- Complications
- Rates of pterygium recurrence
And the findings?
The average duration of surgery was 14.7 minutes, with a duration range of 4 to 39 minutes.
Mitomycin C was also administered in 45% (357 eyes) of patients.
What else?
At the last follow-up visit—ranging from 3 to 94 months, with a median range of 24.5—best-corrected visual acuity (BCVA) was noted as significantly improved from logMAR 0.23 at baseline.
How about the recurrence rate?
Investigators reported a 2.3% rate; of that, only 0.7% (2/274) were patients with primary, single-headed pterygium (and no mitomycin C treatment).
Overall recurrence was higher in cases that were recurrent (4.2%) versus primary (2.1%), double-head (9.1%) versus single-head (2.0%), and treated with MMC (3.2%) versus AM alone (1.3%) (P > 0.05).
Any other complications?
Among that same patient group, post-op effects included:
- Granuloma (7.9%)
- Scarring (3.8%)
- Diplopia (in extreme lateral gaze)(2.5%)
So what does this mean?
The study authors concluded that, following pterygium surgery, the use of the TissueTuck technique with CAM for can be performed in minimal time and with a lower recurrence and complication rate.