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Pterygium Surgery (pterygium + surgery)

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Medical Sciences	100%

Selected Abstracts

Corneal and conjunctival findings after mitomycin C application in pterygium surgery: an in-vivo confocal microscopy study

ACTA OPHTHALMOLOGICA, Issue 2 2009
Andrey Zhivov
Abstract. Purpose:, To perform a qualitative assessment of the topical side-effects of mitomycin C on cornea after pterygium surgery. Methods:,In-vivo confocal microscopy (Heidelberg Retina Tomograph II in combination with the Rostock Cornea Module) was performed in 10 patients with unilateral primary pterygium. Mitomycin C 0.02% was applied topically to seven eyes for 5 min intraoperatively and twice daily for 5 days postoperatively. Three eyes underwent surgery without application of cytostatic agent. Patient follow-up was 1 month. Results:, After application of mitomycin C, complete epithelialization of the operated zone was found 2 weeks after surgery. In-vivo confocal microscopy revealed signs of superficial punctate keratitis for 2 weeks in the central cornea only after application of mitomycin C. The presence of epithelial and stromal oedema in this group was noted for up to 2 weeks in the central cornea and for up to 4 weeks in the operated zone. In the control group, complete epithelialization was found after 1 week; there were no signs of oedema after 1 week in the central cornea or after 2 weeks in the operated zone. Leucocyte infiltration and increased Langerhans cell density were noted in both groups in the operated and central zones. Analysis of the conjunctiva revealed a decrease in goblet cell density following cytostatic application. Conclusion:, Local application of mitomycin C delays corneal epithelialization, and prolongs postoperative epithelial and stromal oedema in both the centre and periphery. Moreover, signs of punctate keratitis were noted 2 weeks after surgery in central intact cornea. Nevertheless, in-vivo confocal microscopy shows that these changes are reversible 4 weeks after application of mitomycin C 0.02%. [source]

Amniotic membrane grafting in the surgical management of primary pterygium

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2004
Rohan W Essex FRANZCO
Abstract Background:,To evaluate the efficacy of amniotic membrane transplantation in primary pterygium surgery. Methods:,Patients presenting to the outpatient clinic of the Royal Victorian Eye and Ear Hospital with primary pterygium requiring surgical management were included in this study. The pterygia were excised to bare sclera and the conjunctival defects were closed with amniotic membrane grafts. The primary outcome was pterygium recurrence. Results:,Twenty-eight pterygia of 26 patients were included. Twenty-three patients (88%, 25 eyes) completed 12 months follow up. By 12 months postoperatively 16 of these eyes (64%) had developed corneal recurrence and a further two had developed a limbal recurrence (9%). Five required repeat surgery during the 12 month follow-up period. No association was found between pterygium recurrence and pterygium size (P = 0.33), amniotic membrane graft dimension (P = 0.12), patient age (P = 0.53) or patient sex (P = 0.63). Conclusion:,Amniotic membrane grafting for primary pterygium was associated with an unacceptably high recurrence rate in this population. [source]

Pterygium surgery long term follow-up

ACTA OPHTHALMOLOGICA, Issue 2009
T WOOD
Purpose To determine if a pterygium surgical procedure consisting of minimal conjunctival removal, excision of the hypertrophic subconjunctival fibrovascular tissue, application of mitomycin 0.25 mg/ml for 1 minute combined with temporary nasal tarsorrhaphy, and postoperative dexamethasone/antibiotic drops achieved the following: safely simplified pterygium removal, controlled the early side effects of mitomycin, reduced the rate of recurrence, and eliminated the need for conjunctival transplantation. Methods Twenty eyes of 19 patients underwent the procedure with mitomycin; fifteen were primary and 5, recurrent. These were compared to a previous group of 28 eyes in 26 patients that underwent pterygium/tarsorrhaphy surgery without mitomycin; twenty had primary and 8 had recurrent pterygia. Postoperatively, all eyes in both groups were treated with dexamethasone/antibiotic drops. Results In the mitomycin group (average follow-up 25 months), 19 of 20 eyes healed uneventfully. At 12 months, there had been no recurrences in the mitomycin group. In the non-mitomycin group (average follow-up 43 months), 9 (32%) recurred within 12 months; four (44%) of these required a second procedure at an average of 9 months. At 23 and 33 months, 2 (10%) eyes treated with mitomycin presented with asymptomatic, one mm recurrences that required no additional treatment. Conjunctival healing, as reflected in the time from surgery until tarsorrhaphy opening, was significantly longer in the mitomycin group, 37 vs. 17 days (P = .001). Conclusion The described technique provided a safe and successful approach to pterygium management. [source]