Therapeutic contact lenses vs. tight bandage patching and pain following pterygium excision: a prospective randomized controlled study

Prat, Daphna Landau; Zloto, Ofira; Artsi, Elad Ben; Simon, Guy J. Ben

doi:10.1007/s00417-018-4118-2

Cited by 19 publications

(18 citation statements)

References 15 publications

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“…Despite the fact that bandage patching may interfere with visual field (thus contraindicated in case of monocular vision), it has been reported that this method procures better pain relief and sleep quality in the first 24 hours after pterygium excision when compared with TCLs. 162 For this reason, tight bandage patching should be preferred over contact lenses if no contraindications to ocular occlusion are observed. TCLs can still be applied in case of persistent pain or corneal defects after the first postoperative day.…”

Section: Clinical Perspectivesmentioning

confidence: 99%

How to minimize pterygium recurrence rates: clinical perspectives

Nuzzi¹,

Tridico²

2018

OPTH

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The main treatment for pterygium is surgical removal. However, pterygium surgery is concerned with high rates of postoperative recurrence. Predicting factors of recurrence are not fully understood, yet, but they probably depend on a multitude of patient-related, clinical, and/or surgical factors. Several adjuvant treatments have been proposed to reduce postoperative pterygium recurrence, including different antimetabolites, antiangiogenetic factors, and radiation therapy. The purpose of this review is to collect the current evidence regarding application and limits of different therapeutic approaches for preventing postoperative recurrence of pterygium, giving insights and perspectives for better management of this disease. In the light of the current evidence, pterygium surgery cannot disregard wound coverage with conjunctival autografting or rotational flap combined with adjuvant treatments. The rotational flap technique is associated with shorter surgical time rates and prevents graft displacement and necrosis, given its vascular pedicle. Amniotic membrane may still be reserved in case of great conjunctival defects or insufficient conjunctiva. Repeated subconjunctival antivascular endothelial growth factor injections can be considered as an effective and safe adjuvant treatment. Moreover, management of postoperative pain is crucial. Innovative treatment strategies will probably target different molecular pathways, considering recent findings regarding pterygium pathogenesis, to improve better understanding and develop universally shared guidelines. Great importance shall be dedicated to the identification of novel molecular biomarkers and favoring factors of recurrence, in order to achieve a customized surgical treatment for each patient and obtain maximal reduction of postoperative recurrence.

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Section: Clinical Perspectivesmentioning

confidence: 99%

How to minimize pterygium recurrence rates: clinical perspectives

Nuzzi¹,

Tridico²

2018

OPTH

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“…Pterygium is a common ocular surface disease, defined as fibrovascular overgrowth of the Tenon's capsule and bulbar conjunctiva onto the cornea. The incidence of pterygium ranges from 0.7% to 31% [1]. The exact pathogenesis of this injury is complex, and it is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Tear Film Instability and Meibomian Gland Dysfunction Correlate with the Pterygium Size and Thickness Pre- and Postexcision in Patients with Pterygium

Wang

Duan

2019

Journal of Ophthalmology

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Purpose This study aimed to evaluate the effects of excision on dry eye and meibomian gland dysfunction (MGD) in individuals with pterygium, before and after surgery. It also aimed to investigate how these effects correlate with the size and thickness of the pterygium. Subjects and Methods 63 eyes from 63 patients with primary nasal pterygium and 45 eyes from 45 healthy volunteers without ocular pathologies were enrolled in this study. 63 eyes from 63 patients underwent pterygium surgery. ImageJ software was used to calculate the pterygium size based on images of the anterior segments. Anterior segment spectral domain optical coherence tomography (SD-OCT) was performed preoperatively to measure the thickness of the pterygium 1 mm anterior to the nasal scleral spur. The ocular surface disease index (OSDI), Schirmer I Test (SIT), and MGD grade were used to evaluate the eyes, and the eyes were imaged using the noninvasive keratograph average tear film breakup time (NIBUTav), tear meniscus height (TMH), meiboscore, and lipid layer grading tools of the Oculus® Keratograph 5M, preoperatively and at 1, 3, and 6 months postoperatively. Results The OSDI, NIBUTav, lid margin abnormality, meiboscore, and lipid layer grading values differed significantly in the pterygium patients in comparison with the controls (p < 0.01 for all scores). However, the SIT and TMH values were unchanged between the two groups (all p > 0.05). Multivariate regression analysis demonstrated that the NIBUTav, meiboscore, and lipid layer grading score was significantly correlated with the pterygium parameters, such as size and thickness. The postoperative OSDI, NIBUTav, lid margin abnormality, and lipid layer grading values improved significantly (p < 0.05 for all scores). The SIT, TMH, and meiboscore results did not differ significantly between the pre- and postoperative values (p > 0.05). Among the conventional and automated indexes, at 1 month postoperatively, SIT and TMH were significantly correlated with the pterygium parameters, but no correlation was observed at 3 and 6 months postoperatively. The OSDI, NIBUTav, meiboscore, and lipid layer grading values at 1, 3, and 6 months postoperatively were significantly correlated with the pterygium parameters. Conclusion Abnormal tear film and meibomian gland (MG) function improved following pterygium excision in the patients with primary pterygium, which was associated with uncomfortable ocular symptoms. Pterygium parameters, such as size and thickness, correlated with the dry eye and MGD indexes in patients pre- and postoperatively, potentially offering a novel strategy for clinical implementation of pterygium excision surgery.

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“…A comparison of the effects of BSCLs after pterygium surgery on reepithelialisation and pain in 39 eyes (20 eyes randomised to the BSCL group, 19 to the no lens control group) found BSCL use significantly reduced pain and enhanced epithelial healing [191]. In a prospective study, pain, discomfort, and sleep quality during the initial 24 h after pterygium surgery were compared between subjects using BSCLs versus subjects who were patching [192]. Interestingly, pain levels were worse and sleep quality was decreased in the BSCL group.…”

Section: Pterygium Surgerymentioning

confidence: 99%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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Therapeutic contact lenses vs. tight bandage patching and pain following pterygium excision: a prospective randomized controlled study

Cited by 19 publications

References 15 publications

How to minimize pterygium recurrence rates: clinical perspectives

How to minimize pterygium recurrence rates: clinical perspectives

Tear Film Instability and Meibomian Gland Dysfunction Correlate with the Pterygium Size and Thickness Pre- and Postexcision in Patients with Pterygium

BCLA CLEAR – Medical use of contact lenses

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