Intraoperative Postoperatively, there was significant improvement in best-corrected visual acuity (P = 0.005) and reduction in magnitude of astigmatism (P = 0.016). 1991 May. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The nasal half was released from its base and placed over the nasal bare sclera without changing the orientation. Outcome of pterygium surgery: analysis over 14 years. [QxMD MEDLINE Link]. Pterygium and ultraviolet radiation:A positive correlation. WebIt has the advantage of low recurrence and complications' rate. Malik KP, Goel R, Gutpa A, Gupta SK, Kamal S, Mallik VK, et al. The .gov means its official. Simple surgical excision has a high recurrence rate of approximately 50-80%. 2011 Mar. To report a case series of pterygium surgery with conjunctival autograft fixation using bipolar electrocautery. Subconjunctival hemorrhage [Fig. Effects of intraoperative steroid injection on the outcome of The recurrence rate, complications, and cosmesis after excision of recurrent pterygia using P.E.R.F.E.C.T. Alaniz-Camino F. The use of postoperative beta radiation in the treatment of pterygia. FOIA 2009 Mar. The complications post pterygium excision and auto-grafting include subconjunctival hemorrhage, graft edema, graft loss, retraction, graft sliding, granuloma, and recurrence. (i) Recurrent pterygium not extending in to cornea, (a) Graft sloughing. Department of Cornea and Phacorefractive, The Eye Foundation, Coimbatore, Tamil Nadu, India, 1Department of Cataract and Refractive, The Eye Foundation, Coimbatore, Tamil Nadu, India. Intraoperative WebA 59-year-old man underwent pterygium excision with intraoperative application of 0.2 mg/ml (0.02%) fact that this patient received the lowest dose used in a series of 25 eyes using the same technique without any other complications. Thus, the material cost of the no glue and no suture method became significantly lower than that of the sutures or using fibrin glue. Grade 3 outcome after pterygium surgery with a bare-sclera technique and intraoperative MMC application. Allan BD, Short P, Crawford GJ, Barrett GD, Constable IJ. The donor site healed without any problem except in two cases which showed granuloma formation at the harvested site and had to be removed surgically [Figure 6]. [QxMD MEDLINE Link]. It has been suggested that radiation activated fibroblasts may result in excessive production of material resulting in pterygia. Before Actinic changes seen on histopathology similar to actinic keratoses on the skin also supports the role of UV radiation. Raiskup F, Solomon A, Landau D, Ilsar M, Frucht-Pery J. Mitomycin C for pterygium: long term evaluation. WebNo intraoperative complication occurred in either group. FOIA Eye Vis (Lond). [QxMD MEDLINE Link]. About 1 cc of 2% Xylocaine (AstraZeneca, UK) was injected into the head of nasal pterygium. Please confirm that you would like to log out of Medscape. The .gov means its official. Conclusion: 112(7):1263-7. Pterygium recurrence rate at the Princess Alexandra Hospital. Using no glue and no suture technique instead of sutures when attaching the conjunctival transplant in pterygium surgery causes significantly less postoperative pain and discomfort and shortens surgery time significantly. (1%). [QxMD MEDLINE Link]. Non-healing epithelial defect (esp with mitomycin C). It may affect the nasal and temporal limbus of both eyes or only a single location. 28 Tarr KH, Constable IJ. An increased incidence is noted in latitudes nearer the equator and in individuals with a history of increased UV exposure (outdoor work). Effects of mitomycin C on corneal endothelial cell counts in pterygium surgery: role of application location. Less commonly corneal melt, perforation. Serious complications of topical mitomycin-C after pterygium surgery. Amniotic membrane graft for primary pterygium:comparison with conjunctival autograft and topical mitomycin C treatment. Effects of Mitomycin C in Early Conjunctival Inflammation after Pterygium Surgery. Subconjunctival injection of triamcinolone resulted in regression of the vessels with no recurrence of pterygium during 12 months of follow-up (c). Excision together with adjunctive therapies such as mitomycin C or 5-fluorouracil can reduce the risk of recurrence to approximately 10%[10]. [Fig.1f1f and and1g]1g] was seen in 4 cases (0.16%) at the host site and 5 cases (0.21%) at the donor site. Bethesda, MD 20894, Web Policies The second case did not have any recurrence. Miyai T, Hara R, Nejima R, Miyata K, Yonemura T, Amano S. Limbal allograft, amniotic membrane transplantation, and intraoperative mitomycin C for recurrent pterygium. In both groups, recurrence was noticed between 5 months to 13 months post-surgery. Please enable it to take advantage of the complete set of features! Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of OphthalmologyDisclosure: Nothing to disclose. The graft was secured on both sides with fibrin glue, Tisseel VH (Baxter AG, Vienna, Austria) ensuring complete coverage of the bare sclera on both sides. and transmitted securely. In this paper, we have shown that the use of no sutures, no glue technique when securing the autologous conjunctival graft in pterygium surgery causes significantly less pain than using sutures. Our study has limitation that it comprised a small study population of the designated area. A yellowish transplant serous edema was sometimes observed and was slightly more common in the mitomycin used group. Interim Clinical Treatment Considerations for Severe Manifestations of Mpox, Artificial Intelligence and Corneal Diseases, Perioperative Care of the Patient With eye Pathologies Undergoing Nonocular Surgery, FDA Drug Approvals and Changes: August Edition, Recent Advances in Cell-Based Regenerative Therapies for Corneal Disease, Highlights in Corneal Disorders From AAO 2022, Advances in Macular Degeneration From AAO 2021. Medscape Education, Patient and Lens Selection: An In-Depth Exploration of Intraocular Lenses for Patients With Presbyopia and Cataracts, encoded search term (Pterygium) and Pterygium. D'Ombrain A. [QxMD MEDLINE Link]. There were no other postoperative complications such as graft detachment, or formation of dellen or granulomas. An official website of the United States government. Hirst LW. The lids are closed, and pressure bandage was applied for 24 h. Surgery time was noted from the first incision until the lid speculum was removed. The head of the pterygium was avulsed and fibrovascular tissue was excised with conjunctival scissors. [QxMD MEDLINE Link]. In this retrospective study, we have tried to analyze the complications post pterygium, both immediate and long term for a better understanding of the complication profile. Table 2 mentions the list of all the complications with their respective percentage. It can be noted that it was significantly more in recurrent pterygia about 75.69% (P < 0.05). There were two cases with transplant loss on the 1st postoperative day and were treated as bare sclera technique. In addition, the time cost is significantly lower than that of with sutures. Conclusions: [7] and (2) engaging in occupations that require outdoor activities. WebConclusions: In pterygium surgery with a bare-sclera technique and mitomycin C application, intraoperative triamcinolone injection did not significantly reduce postoperative conjunctival The entered sign-in details are incorrect. The follow-up period ranged from 6 months to 75 months, with an average of 17 months. Syawal P, Budu B, Hatta M, Massi MN, Ichsan AM, Minhajat R. J Taibah Univ Med Sci. Taylor HR, West SK, Rosenthal FS, Munoz B, Newland HS, Emmett EA. Patients referred to our hospital for pterygium surgery were enrolled in the study. The conjunctival graft was taken from the superior conjunctiva. WebTheir use can be associated with significant sight-threatening complications such as corneal endothelial cell loss, scleral ulceration, melting, and even perforation. 2011 Nov;152(5):733-8. doi: 10.1016/j.ajo.2011.04.013. intra- Recurrence [Fig. [9] reported recurrence in one eye (2.5%) out of 40 cases and dehiscence in 2 cases. In the present study, we sought to determine the safety and efficacy of using glueless and sutureless technique of conjunctival autografts and to compare the results of such technique with the use of Vicryl sutures in patients undergoing pterygium excision. The pterygia in this group have a more aggressive clinical course and a higher rate of recurrence following excision. Methods The effectiveness of intraoperatively administered mitomycin C and the occurrence of postoperative complications were evaluated The site is secure. As a library, NLM provides access to scientific literature. (e) Retraction of the graft. All the cases with nasal gaping healed well in due course of time and did not require any surgical intervention, Two cases reported with granuloma formation at the graft harvested site which was removed surgically, We report recurrence rate of 6.8% (14 cases), which is slightly higher than pterygium surgery with autograft using sutures, This technique works well with the use of mitomycin C and in recurrent pterygium. 1892. Threlfall TJ, English DR. Sun exposure and pterygium of the eye: a dose-response curve. Evaluation of Primary Pterygia on Basis of the Loss of Vertical Length of Plica Semilunaris. Design: A noncomparative, retrospective, As a library, NLM provides access to scientific literature. E-mail: Received 2020 Sep 24; Revised 2021 Jan 26; Accepted 2021 Feb 7. Conjunctival recurrence of pterygium was seen in 2 (8.7%) of the steroid group and in 1 (4.0%) of the control group (P=0.47). Pterygium: Surgical Techniques and Choices - PMC intraoperative After the pterygium was excised, the bare complications of pterygium Kheirkhah A, Nazari R, Nikdel M, et al. A retrospective analysis was done to know the complications post pterygium excision with conjunctival autografting. [15] to evaluate the effectiveness of fibrin glue compared to sutures in conjunctival autografting for the surgical treatment of pterygium showed that fibrin glue had fewer recurrence rates and the time taken for the surgery was reduced compared to sutures for fixing the conjunctival graft in place during pterygium surgery. Patients rated their cosmesis as excellent in all cases [Figures [Figures224], and photographic comparison of nasal to temporal conjunctiva at last review revealed no obvious cosmetic defects. Complications occurring after pterygium surgery with adjunctive MMC have been well reported with different modalities of application, concentrations and durations. The recurrence was defined as fibrovascular tissue growth of 1.5 mm or more beyond the limbus onto the clear cornea with conjunctival dragging. 1990 Oct. 9(4):331-4. A total of 111 consecutive patients with recurrent pterygium removals. Ti SE, Chee SP, Dear KB, Tan DT. [QxMD MEDLINE Link]. government site. WebAbstract. Carcinogenesis by Ultraviolet Light. Minimally Invasive Pterygium Surgery: Sutureless Excision with Amniotic Membrane and Hydrogel Sealant. Complications, conjunctival autograft, conjunctival limbal autograft, pterygium. Pterygium surgery with mitomycin-C: ten-year results. MeSH 8600 Rockville Pike Pterygium - Complications | BMJ Best Practice Outcomes of conjunctival autograft in primary pterygium cases in other studies[5,16,17,18,19] are listed in Table 3, in our study largest sample size is been considered. There were no intraoperative complications reported except in two cases where we had to use sutures for securing the graft as we noticed graft was not attaching well with undersurface in these two patients. 2022 Jan 6;33(4):367-378. doi: 10.4103/joco.joco_153_20. Excessive hemorrhage in the graft bed is tamponed. Yin M, Li H, Zhang Y, Dai H, Luo F, Pan Z. Interferon Alpha-2b Eye Drops Prevent Recurrence of Pterygium After the Bare Sclera Technique: A Single-Center, Sequential, and Controlled Study. official website and that any information you provide is encrypted The site is secure. The transplants healed with excellent cosmetic result. doi: 10.1002/14651858.CD011349.pub2. National Library of Medicine We feel that the rate of recurrence between sutured graft (4.7%) and nonsutured graft (6.8%) is definitely significant. William B Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive SurgeryDisclosure: Received consulting fee from Allergan for consulting; Received consulting fee from Alcon for consulting; Received consulting fee from Bausch & Lomb for consulting; Received consulting fee from Abbott Medical Optics for consulting; Received consulting fee from CXLUSA for none; Received consulting fee from LensAR for none. Clearfield E, Muthappan V, Wang X, Kuo IC. [QxMD MEDLINE Link]. Histologically, pterygia are an accumulation of degenerated subepithelial tissue which is basophilic with a characteristic slate gray appearance on H&E staining. The diagnosis is most often clear clinically, but histopathologic confirmation is performed routinely, as there can be associated dysplasia of the overlying tissue. Objective: As majority of the patients in our study were not literate enough, so proper counseling was done by Arabic-speaking staff in the department, and all patients were instructed how to use the visual analog score during the postoperative week. Recurrent pterygium surgery using pterygium extended removal Kaufman SC, Jacobs DS, Lee WB, Deng SX, Rosenblatt MI, Shtein RM. pterygium surgery 1999 Aug;106(8):1512-5. doi: 10.1016/S0161-6420(99)90445-1. There have been many attempts to optimize pterygium surgery. Other severe complications like corneal melt [Fig. Corneal melt was noted in only one case which had recurrent pterygium and none of the cases had scleral perforation or melt. Furthermore, they have different ability to report their experience. 112(4):667-71. Anduze AL. for pterygium) indicate a further decreased recurrence rate (as low as 1 in 1000 in one series)[7][8][9]. Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of OphthalmologyDisclosure: Nothing to disclose. All these techniques involve the use of sutures or fibrin glue and are therefore vulnerable to associated complications. Postoperative Complications* Complications of pterygium surgery. To avoid the pterygium growing back, you should take the prescribed steroid drops and avoid sun exposure to the eye. (c) Subconjunctival hemorrhage/haematoma. 2005 Apr. Accessibility Epub 2012 Oct 11. Pterygium is one of the commonly performed surgeries in South India due to its increased prevalence here, because of the hot climatic conditions. The conventional method of managing pterygium in cataract cases is to perform the pterygium surgery first followed by phacoemulsification. [25,26,27] The other complications in primary and recurrent pterygium with significant P value (<0.05) were graft edema and graft loss. Epub 2014 Jan 31. Arch Ophthalmol. A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium. Limbal-conjunctival vs conjunctival autograft transplant for recurrent pterygia:A prospective randomized controlled trial. 2c] which did not cause any symptoms to the patient. Hall AB. Retrospective analysis of all the patients who had undergone pterygium excision in a tertiary center in South India from 2010 to 2018 was analyzed.
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