Developments and current approaches in the treatment of pterygium

Hacıoğlu, Dilek; Erdöl, Hidayet

doi:10.1007/s10792-016-0358-5

Cited by 57 publications

(47 citation statements)

References 81 publications

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“…Pterygium excision with CAG or CLAG is the method of choice for most surgeons. The results of recent studies indicate on 3-10% recurrence rate after CAG procedure (27)(28)(29) but it may range up to 30% (for recent review see 30). The limbal conjunctival autograft procedure seems to be a little more effective than CAG with recurrence rate varies between 0 and 15% (for recent review see 30) but this process requires more experience.…”

Section: Discussionmentioning

confidence: 99%

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

Nowacka¹,

Lubiński²

2019

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Objectives: The aim of the study was to evaluate changes in corneal astigmatism and recurrence rates of two variants of 'sliding flap' techniques -with intraoperative use of 0.05% mitomycin C or 20% ethyl alcohol which could be an option for other pterygium surgeries. Material and Methods: Fifty eyes from 45 patients with primary pterygia were included. All patients underwent the 'sliding flap' surgery performed by a single surgeon with adjunctive intraoperative 0.05% mitomycin C (group MMC-27 eyes) or 20% ethyl alcohol (group ALC-23 eyes) therapy. Follow-up visits were at months 1, 3, 6 and 12. Patients were examined in the slit lamp for pterygium recurrence defined as any fibrovascular growth of conjunctival tissue extending across the limbus. Moreover, before and 12 months after surgery keratometry was performed in order to estimate corneal astigmatism (only in eyes without pterygium recurrence). Results: During 12 moths of follow-up, only two recurrences (7.4%) were observed in the MMC group and 3 (13.0%) in the ALC group. In both groups, there was a visible but statistically insignificant reduction in corneal astigmatism compared to the preoperative measurement (before the surgery > MMC group: 1.2 ± 0.8 Dcyl, ALC group 1.3 ± 1.3 Dycl, 12 months postoperatively > MMC group: 0.9 ± 0.7 Dcyl, 0.8 ± 0.6 Dcyl, respectively). Conclusions: The 'sliding flap' techniques combined with intraoperative 0.05% MMC or 20% ethanol application are equally effective surgical alternatives for preventing recurrence of primary pterygium. The procedures are simple with a satisfactory cosmetic effect and lack of major complications. Abstrakt:Cel pracy: Celem pracy była ocena częstości nawrotów oraz zmian astygmatyzmu rogówkowego dwóch wariantów operacji usunięcia skrzydlika z przesunięciem płatka spojówki -ze śródoperacyjnym zastosowaniem 0,05% mitomycyny lub 20% alkoholu etylowego, które mogą stanowić alternatywę dla innych technik. Materiał i metody: Do badania zakwalifikowano 50 oczu z pierwotnym skrzydlikiem od 45 pacjentów. U wszystkich pacjentów wykonano operację usunięcia skrzydlika z przesunięciem płatka spojówki oraz śródoperacyjnym zastosowaniem 0,05% mitomycyny C (grupa MMC -27 oczu) lub 20% alkoholu etylowego (grupa ALC -23 oczu). Zabiegi były wykonywane przez jednego operatora. Wizyty kontrolne miały miejsce w 1, 3, 6 i 12 miesiącu po zabiegu. Pacjentów badano za pomocą lampy szczelinowej pod kątem nawrotu skrzydlika, który definiowano jako jakikolwiek rozwój tkanki włóknisto-naczyniowej przekraczający rąbek rogówki. Ponadto, przed i 12 miesięcy po zabiegu wykonano keratometrię w celu oceny astygmatyzmu rogówki (tylko w oczach bez nawrotów skrzydlika). Wyniki: W ciągu 12 miesięcy zaobserwowano tylko dwa nawroty (7,4%) w grupie MMC i 3 (13,0%) w grupie ALC. W obu grupach była widoczna, ale statystycznie nieistotna redukcja astygmatyzmu rogówki w porównaniu z przedoperacyjnym pomiarem (przed operacją > grupa MMC: 1,2 ± 0,8 Dcyl, grupa ALC 1,3 ± 1,3 Dycl, 12 miesięcy po zabiegu > grupa MMC: 0,9 ± 0,7 Dcyl, 0,8 ± 0,6 Dcyl)...

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Section: Discussionmentioning

confidence: 99%

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

Nowacka¹,

Lubiński²

2019

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“…This is a small number of cases, and the fact that there was no recurrence during follow up, cannot exclude this possibility. In the literature the reported recurrence rate for conjunctival grafts is 5-30%, while for AMT is 5-40% [20]. In those cases, and the fact that these techniques are usually performed for big recurrent pterygia, a good cover with conjunctival epithelium or amnion is essential in promoting healing and inhibiting proliferation of fibrovascular tissue.…”

Section: Discussionmentioning

confidence: 99%

Long Term Results of Pterygium Excision Using Different Surgical Techniques: A Retrospective Study

Lubbad¹,

Giarmoukakis²,

Skatharoudi³

et al. 2017

J Clin Exp Ophthalmol

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Purpose: To retrospectively analyze data related to results of different techniques of pterygium surgery performed in the Cornea Service of the Department of Ophthalmology at the Heraklion University Hospital of Crete between the years 1998-2015.Methods: Data from patients that completed at least 10 months of follow up were included in the study. Out of 115 eyes of 110 patients 80 eyes were operated for primary and 35 for recurrent pterygium. The surgical techniques included surgical excision with bare sclera (BSE), with and without the intraoperative 4 minute use of Mitomycin-C 0.02% (BSE+MMC), as well as surgical excision with conjunctival autograft (CAU) or amniotic membrane transplantation (AMT)Results: During the mean follow up of 20+16.3 months, the overall recurrence rate was 9.6% (11 cases). BSE technique resulted in 16.7% recurrence (2 cases) in 12 primary pterygia, while 6 out of 68 primary pterygia (8.8%) recurred after BSE+MMC. Recurrent cases operated with BSE+MMC had 13% recurrence rate (3 out of 23), while none of the eyes that underwent CAU (9 cases) or AMT (3 cases) had another recurrence. Conclusion:The long term results of the current study for different surgical techniques of pterygium excision are in accordance with the literature reports. Authors recommend the use of BSE+MMC for primary and quiet recurrent pterygia cases as being fairly effective, and CAU or AMT for invasive recurrent or even "angry" primary pterygia.

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“…Surgery is the only recognized and effective treatment for pterygium. However, although there are various surgical methods for the treatment of pterygium, there has been no consensus yet on which surgical method is the best choice [1][2][3]. The recurrence rate of pterygium is the main challenge for ophthalmologists [4,5]; therefore, it is important to choose the most appropriate and effective surgical method for the treatment of pterygium [6,7].…”

Section: Introductionmentioning

confidence: 99%

Limbal-conjunctival Autograft Transplantation Versus Conjunctival Autograft Transplantation In The Treatment Of Pterygium: A Self-control Study

Wang¹,

Gu²,

Zhang³

et al. 2019

Preprint

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Background : Pterygium is a common ocular growth, which affects vision, ocular surface function, and aesthetics of the eye. Although various surgical methods are used for treating pterygium, there has been no consensus on the most suitable method. Therefore, it is important to choose the most appropriate and effective surgical method for the treatment of pterygium. The aim of this study was to compare the characteristics and efficacy of limbal-conjunctical autograft transplantation and conjunctival autograft transplantation for the treatment of pterygium. Methods : From August 2015 to December 2016, 80 patients with bilateral primary pterygium in Minhang Hospital affiliated to Fudan University were treated with limbal-conjunctival autograft transplantation in one eye (group A) and conjunctival autograft transplantation in the fellow eye (group B). The operative times of the two surgical methods were compared. The corneal epithelial healing times and recurrence rates for the two methods were observed and recorded after two years of follow-up. Results : Eight patients dropped out of the study and 72 patients participated in the final evaluation. The average operative time for group A and group B was 27.56 1.48 minutes and 26.91 1.39 minutes, respectively. There was no significant difference between the operative times for the two groups (t = 1.93, P = 0.058). The average corneal epithelial healing time for groups A and B was 2.56 0.34 days and 4.85 0.49 days, respectively (t=25.26, P < 0.001). Two years after the surgery, pterygium recurred in two eyes (2.78%) in group A and in nine eyes (14.29%) in group B. The difference between the two groups was statistically significant (2=4.82, P=0.028). Conclusion : In primary pterygium surgery, the healing time of the corneal epithelium after limbal-conjunctival autograft transplantation is shorter than that after conjunctival autograft transplantation, and the pterygium recurrence rate after limbal-conjunctival autograft transplantation is lower than that after autologous conjunctival transplantation. Although both limbal-conjunctival autograft transplantation and conjunctival autograft transplantation can achieve good clinical results, limbal-conjunctival autograft transplantation is superior to conjunctival autograft transplantation in terms of the corneal epithelial healing time and recurrence rate of pterygium after surgery.

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Developments and current approaches in the treatment of pterygium

Cited by 57 publications

References 81 publications

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

Long Term Results of Pterygium Excision Using Different Surgical Techniques: A Retrospective Study

Limbal-conjunctival Autograft Transplantation Versus Conjunctival Autograft Transplantation In The Treatment Of Pterygium: A Self-control Study

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