Update on overview of pterygium and its surgical management

Abstract

Pterygium is a bulbar conjunctival fibrovascular growth that crosses the limbus and extends onto the peripheral cornea, and in some cases leads to significant visual complications. The prevalence of this disease has been reported to be from 1.2% to about 40% in different parts of the world. Although there are various risk factors for pterygium, which include ultraviolet (UV) radiation, viral infection, hereditary factors, immune factors, aseptic inflammation, and environmental irritation, the pathogenesis of pterygium is mainly related to exposure to UV light. In addition to cosmetic problems, pterygium can lead to eye irritation, disrupt the transparency of cornea on the pupil area, and cause disorders such as corneal astigmatism and damage to the visual axis leading to vision impairment. In the last few years, the treatment of pterygium has been developed and various new solutions have been used. Surgery is the main treatment for pterygium. Various techniques such as Bare Sclera, Rotational Conjunctival Flap, Limbal Conjunctival Autograft, Amniotic Membrane Graft, and Free Conjunctival Autograft are used for the removal of pterygium. It also seems that the worrisome problem of recurrence has been significantly reduced with newer treatment methods. On the contrary, the use of auxiliary treatments such as mitomycin C, b-radiation, 5-fluorouracil, topical use of interferons, and Avastin are also effective in reducing the recurrence rate.

The Role of Insulin-like Growth Factor (IGF) System in the Corneal Epithelium Homeostasis—From Limbal Epithelial Stem Cells to Therapeutic Applications

“…Moreover, IGF-2 has been shown to stimulate LESC differentiation, evidenced by the expression of K12 cell markers [ 34 ]. Pterygium, a common degenerative condition resulting in conjunctival overgrowth which may extend beyond the limbus and involve the cornea [ 153 ], was found to exhibit overexpression of IGF-2 and IGF-1R compared to normal conjunctiva, as revealed by immunohistochemical analysis [ 154 ].…”

Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis

“…Pterygium is a common ocular disorder characterised by a wing-shaped fibrovascular growth from the conjunctiva onto the cornea, with nasal involvement being more common than temporal involvement. 1 2 Chronic ultraviolet (UV) exposure is the primary risk factor, along with other factors such as smoking, low income, rural living, alcohol consumption, older age, male gender and outdoor occupations. 3 4 The global prevalence of pterygium is approximately 12%.…”

Pilot Study of Seamless Diplen Membrane for Pterygium Excision

“…However, the standard procedure of suturing conjunctival grafts has certain disadvantages, such as inadequate attachment of large conjunctival grafts within the graft itself, jagged edges of the graft, the development of retraction between the sutures, and prolonged suturing time compared to the actual excision of pterygium and graft dissection. 5 However, it is worth noting that the standard procedure for fixing conjunctival grafts with sutures has certain disadvantages: inadequate attachment of large conjunctival grafts placed inside the graft itself; uneven (jagged) edges of the graft, retraction between the sutures; sometimes time of suturing exceeds the actual excision of the graft. 6 Thus, search for an optimal method of treating pterygium, one that minimizes risk of relapses and complications and ensures cosmetic safety, remains a subject of interest, controversy and discussion in modern ophthalmology.…”