ABSTRACT
Purpose: The aim of this study is to describe a modified technique of using conjunctival tissue from the pterygium itself without any rotation of graft for the primary pterygium in eyes with glaucoma filtering bleb, glaucoma suspects, and in primary double-head pterygium using fibrin glue. Methods: In this retrospective, noncomparative, interventional case series, 98 eyes of 98 patients with primary pterygium operated between July 2011 to July 2016 were included. They underwent this technique from the pterygium tissue itself. There was no rotation of this graft, and it was adhered to the bare scleral defect with fibrin glue. Histopathological analysis of pterygium tissue was done to look for morphology and thickness of this thin conjunctival tissue obtained from pterygium tissue itself. The primary outcome measure was recurrence rate. Other outcome measures studied was graft retraction and graft edema. Results: The mean age was 52 ± 10.04 years. Mean follow-up was 14 ± 8.24 months. The only significant complication was recurrence rate of 4.08% (4 eyes out of 98). The most come secondary outcome was graft edema, 52.04% (51 eyes out of 98) which resolved without any intervention. Other outcome such as graft retraction, 32.65% was also recorded. Conclusion: Conjunctival tissue from the pterygium tissue itself without actual rotation appears to be a successful technique with lower recurrence rate for treating primary pterygium in eyes with glaucoma filtering bleb, glaucoma suspects, and in primary double-head pterygium.
ABSTRACT
@#BACKGROUND. To observe the efficacy and the safety of low-dose mitomycin-C (MMC) in the treatment of pterygium. MATERIAL AND METHODS. In a prospective, randomized and controlled clinical trial, a total of 550 eyes of 400 patients diagnosed with pterygium were randomly divided into the four groups - group 1:130 eyes of 100 patients without MMC; group 2:140 eyes of 100 patients , with 0.2g\L MMC; group 3:150 eyes of 100 patients, with 0.3g\L MMC; group 4:130 eyes of 100 patients, with 0.4g\L MMC. They underwent the excision of primary pterygium barely the sclera. Visual acuity, intraocular pressure (IOP), extraocular movement, iridocyclitis, scarring, symptoms (tearing, photophobia, foreign body sensation) and signs (conjunctival hyperemia, ulcer of sclera and cornea, perforation of sclera) of subjects, were recorded on the day of enrollment and after the surgery, on 2 weeks, 2 months, 6 months and 1 year. RESULTS. In a group 3 and 4, the recurrence of pterygium after the excision were less than that in group 1 and group 2 (р<0.01) . In a 4 group, after the surgery, there were more probability of raising IOP, iridocyclitis, symptoms and signs than that in group 1,2, and 3. СONCLUSION. Low dose MMC is effective in the treatment of preventing the recurrence of primary pterygium. It’s efficacy rises along with its density. And mean time, the safety of the treatment of low-dose MMC declines.
ABSTRACT
Objetivo: Evaluar la ocurrencia de recidivas y otras complicaciones con el uso de Mitomicina C intraoperatoria en la cirugía de pterigio. Diseño del estudio y métodos: Se diseñó un estudio de retrospectivo, comparando la aplicación de Mitomicina C 0,1% intraoperatoria con la realización de injerto en la cirugía de pterigion en la clínica Medyser de Bucaramanga, Colombia. Se estudiaron un total de 305 ojos operados en este centro entre el primero de marzo de 2014 y el 29 de febrero de 2016, distribuidos en dos grupos, 126 ojos en el grupo de expuestos y 179 ojos en el grupo de no expuestos. Resultados: Se encontró que existe un factor protector del uso de Mitomicina C aplicada intraoperatoriamente para disminuir la incidencia de complicaciones como el dellen corneal, presencia de recidivas, leucoma residual, sobreinfección, hemorragia subconjuntival, haze corneal y rasgado por la sutura, con mayor riesgo de presentar granulomas y reabsorción del injerto. Conclusiones: De acuerdo a esto, la utilización de la Mitomicina C se presenta como una alternativa muy segura y eficaz en el manejo quirúrgico del pterigion, usada al 0,1% por 30 segundos, como se propone; sin embargo, se hace necesario diseñar un ensayo clínico comparativo con el gold standard actual como es la realización del injerto libre con células limbares.
Objective: To evaluate the pterygium recurrence and complications by the use of Mitomycin C during surgery. Study Design and Methods: We designed a retrospective study, comparing the application of Mitomycin C 0,1% intraoperative with the use of a graft in pterygium surgery at the Medyser Clinic in Bucaramanga Colombia, we studied 305 eyes operated at this center between the fi rst March 2014 and 29 February 2016 and were distributed into two groups: 126 eyes in the exposed group and 179 eyes in the non-exposed group. Results: We found there is a protective factor in the use of Mitomycin C applied intraoperatively to decrease the incidence of complications as the corneal dellen, pterygium recurrence, residual leucoma, infection added, conjunctival hemorrhage, haze corneal and graft rupture by suture, with greater risk of granulomas presence and graft resorption. Conclusions: Accordingly, the use of Mitomycin C appears as a very safe and effective alternative, using a 0,1% by 30 seconds, as e proposed, in the surgical management of pterygium; however, it is necessary to design a comparative clinical trial with the today's gold standard as it is the realization of free graft with limbal cells surgery.
Subject(s)
Pterygium , Mitomycin , Ophthalmologic Surgical Procedures , RecurrenceABSTRACT
Aims: To evaluate the efficacy of repeated bevacizumab injection in rotational conjunctival flap surgery versus rotational conjunctival flap with adjunctive mitomycin C (MMC) or rotational conjunctival flap alone. Materials and Methods: Ninety eyes of 90 patients who underwent primary pterygium surgery with rotational flap were evaluated. Patients were randomly assigned to undergo conjunctival rotational flap alone (Group A) or conjunctival rotational flap with either 0.02% MMC application (Group B) or adjunctive subconjunctival 2.5 mg/0.1 ml bevacizumab injection (Group C). Each group consisted of 30 eyes. Recurrence rates at 9 months were evaluated. Results: There were no statistically significant differences in mean size of the pterygium across the limbus in terms of length (P > 0.5). The recurrence rates at 9 months were 26.6% (n = 8) in Group A, 13.3% (n = 4) in Group B, and 10% (n = 3) in Group C. The recurrence rates in Group B and C were significantly lower than in Group A (P = 0.1806). The recurrence rates were similar in Group B and C (P > 0.05). Conclusions: Subconjunctival bevacizumab injection may decrease the recurrence rate of primary pterygium surgery with rotational conjunctival flap. Further studies with a larger population and longer follow‑up period are needed to supplement this study.