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Surgically induced necrotizing scleritis after pterygium surgery  [cached]
Gokhale Nikhil,Samant Rohini
Indian Journal of Ophthalmology , 2007,
Abstract: We report a case of surgically induced necrotizing scleritis following pterygium surgery with the bare sclera technique, without the use of adjunctive irradiation or mitomycin C. The patient was successfully treated with systemic immunosuppression.
Comparing techniques for pterygium surgery
Atilla Alpay, Suat Hayri Ugurbas, Berktug Erdogan
Clinical Ophthalmology , 2009, DOI: http://dx.doi.org/10.2147/OPTH.S2767
Abstract: mparing techniques for pterygium surgery Original Research (7455) Total Article Views Authors: Atilla Alpay, Suat Hayri Ugurbas, Berktug Erdogan Published Date September 2008 Volume 2009:3 Pages 69 - 74 DOI: http://dx.doi.org/10.2147/OPTH.S2767 Atilla Alpay, Suat Hayri Ugurbas, Berktug Erdogan Department of Ophthalmology, Faculty of Medicine, Zonguldak, Karaelmas University, Zonguldak, Turkey Purpose: To compare various techniques of pterygium surgery including bare sclera, intraoperative mitomycin C application, conjunctival flap reconstruction, and conjunctival autografting technique. Methods: This study is designed to compare 4 currently used techniques in order to determine the complication and recurrence rates after pterygium exision. Included in the study were 77 eyes from 60 patients. Bare sclera technique was used to treat 21 primary pterygia; mitomycin C was used to treat 20 (16 primary, 4 recurrent) pterygia; 18 (17 primary, 1 recurrent) pterygia were treated by conjuntival flap reconstruction; and 18 (9 primary, 9 recurrent) pterygia were treated by conjunctival autografting technique. All patients who underwent surgery were followed up for between 6 months and 2 years. Results: Eight recurrences (38.09%) were observed in the bare sclera group whereas there were 5 (25%) recurrences in the mitomycin C group. In the conjunctival flap reconstruction group, 6 (33.33%) recurrences were detected. In the conjunctival autografting group, 3 recurrences were observed. There were no major complications threatening visual ability in the surgical patients. Conclusion: A comparison of the groups demonstrated that the recurrence rate was highest in the bare sclera group, and lowest in conjunctival autografting and mitomycin C treatment groups respectively. Although the conjunctival autografting technique is a more difficult and time consuming technique than the others, cosmetic and surgical results were found to be superior. We advise conjunctival autografting for the treatment of pterygium in view of the high recurrence rates of other techniques, and the possible complications of mitomycin C treatment for benign disease.
Comparing techniques for pterygium surgery  [cached]
Atilla Alpay,Suat Hayri Ugurbas,Berktug Erdogan
Clinical Ophthalmology , 2008,
Abstract: Atilla Alpay, Suat Hayri Ugurbas, Berktug ErdoganDepartment of Ophthalmology, Faculty of Medicine, Zonguldak, Karaelmas University, Zonguldak, TurkeyPurpose: To compare various techniques of pterygium surgery including bare sclera, intraoperative mitomycin C application, conjunctival flap reconstruction, and conjunctival autografting technique.Methods: This study is designed to compare 4 currently used techniques in order to determine the complication and recurrence rates after pterygium exision. Included in the study were 77 eyes from 60 patients. Bare sclera technique was used to treat 21 primary pterygia; mitomycin C was used to treat 20 (16 primary, 4 recurrent) pterygia; 18 (17 primary, 1 recurrent) pterygia were treated by conjuntival flap reconstruction; and 18 (9 primary, 9 recurrent) pterygia were treated by conjunctival autografting technique. All patients who underwent surgery were followed up for between 6 months and 2 years.Results: Eight recurrences (38.09%) were observed in the bare sclera group whereas there were 5 (25%) recurrences in the mitomycin C group. In the conjunctival flap reconstruction group, 6 (33.33%) recurrences were detected. In the conjunctival autografting group, 3 recurrences were observed. There were no major complications threatening visual ability in the surgical patients.Conclusion: A comparison of the groups demonstrated that the recurrence rate was highest in the bare sclera group, and lowest in conjunctival autografting and mitomycin C treatment groups respectively. Although the conjunctival autografting technique is a more difficult and time consuming technique than the others, cosmetic and surgical results were found to be superior. We advise conjunctival autografting for the treatment of pterygium in view of the high recurrence rates of other techniques, and the possible complications of mitomycin C treatment for benign disease.Keywords: pterygium, comparing, techniques, mitomycin C
Complications following Use of Intraoperative Mitomycin-C in Pterygium Surgery.  [PDF]
Imtiyaz Ahmad, Reyaz Ahmad Untoo, Sheikh Sajjad.
JK Science : Journal of Medical Education & Research , 2004,
Abstract: This study was designed to evaluate the possible complications following the use of intraoperativemitomycin-C in patients undergoing surgery for primary pterygium. Hundred eyes of 88 patients withprimary pterygium were operated upon using ''bare sclera technique''. Intraoperatively all the patientswere applied freshly prepared mitomycin-C 0.02% (0.2 mg/ml) on the bare sclera for a period of 5 minutes,after which the eyes were thoroughly rinsed with a sterile balanced salt solution. Postoperatively, none ofthe patients recieved mitomycin-C eye drops. After a mean postoperative followup of 14 months, 4 eyes(4%) of 4 patients developed thinning of the sclera with visualization of the underlying uveal tissue. Oneeye (1%) developed extreme thinning of the sclera with ectasia of the underlying uveal tissue, requiringa scleral patch. Recurrence was seen in 2 eyes (2%) only. The study shows that although intraoperativemitomycin-C (0.02%) reduces the recurrence of pterygium, it leads to serious, cosmetically unacceptableand even sight-threatening complications.
Intraoperative Ethanol Treatment as an Adjuvant Therapy of Pterygium Excision  [cached]
Ko-Hua Chen,Ko-Hua Chen,Ko-Hua Chen,Wen-Ming Hsu
International Journal of Biomedical Science , 2006,
Abstract: Recurrence of pterygium is the main concern for ophthalmic surgeons after the excision of pterygium. To evaluate the efficacy and safety of ethanol treatment during pterygium excision in preventing the recurrence of pterygia, a prospective randomized study was performed of 78 eyes in primary pterygium patients treated by excision. Primary pterygium patients were randomly assigned to ethanol group (38 eyes given intraoperative ethanol) or mitomycin-c (MMC) group (40 eyes given intraoperative MMC). Ethanol (20%) was applied for 60 seconds to the pterygial and its adjacent corneal surfaces before pterygium excision. After excision, the excised site of sclera was soaked with 20% Ethanol for 60 seconds. In group 2, MMC (0.25 mg/ml) was applied for 60 seconds to the bare sclera after pterygium excision. The outcomes were followed for more than one year. Pterygium recurred in 2 (5.3%) of 38 eyes in ethanol group and 4(10.0%) of 40 eyes in MMC group. Final appearance of the pterygium excision area was satisfactory in 73.6% of group1 and 67.5% of group 4. No patients experienced severe complications postoperatively. In comparison with MMC treatment, intraoperative ethanol is more efficacious in preventing recurrence of pterygium and causes fewer complications. It suggests this regimen as an alternative for the treatment of pterygium, especially for those patients of high risk group for MMC treatment complications.
Pre- and intraoperative mitomycin C for recurrent pterygium associated with symblepharon
Mohammed I
Clinical Ophthalmology , 2013, DOI: http://dx.doi.org/10.2147/OPTH.S40472
Abstract: e- and intraoperative mitomycin C for recurrent pterygium associated with symblepharon Case report (817) Total Article Views Authors: Mohammed I Published Date January 2013 Volume 2013:7 Pages 199 - 202 DOI: http://dx.doi.org/10.2147/OPTH.S40472 Received: 19 November 2012 Accepted: 12 December 2012 Published: 23 January 2013 Isyaku Mohammed Department of Ophthalmology, Aminu Kano Teaching Hospital, Kano, Nigeria Background: Treatment of recurrent pterygium associated with symblepharon usually involves the use of tissue grafting and/or the intraoperative application of mitomycin C (MMC). For the graft, a conjunctival/limbal autograft and/or amniotic membrane may be used. This generally requires extra technical skills and assistance, an increase in the cost and duration of surgery, and a more extensive anesthesia (a complete eye block or general anesthesia). Although widely used, safety concerns have been raised over MMC in the treatment of pterygia. Objective: The objective of this case report is to report the successful use of preoperative subconjunctival injection of low-dose (0.02%) MMC one month before bare sclera excision of a multirecurrent pterygium, as well as the concomitant intraoperative application of MMC to the conjunctival fornix of the same eye after the excision of an associated symblepharon. Case report: A 31-year-old man from Kano, Northern Nigeria, presented to the eye clinic with a recurrent pterygium associated with an upper lid symblepharon in his right eye. He has had five previous pterygium excisions, with the last surgery involving conjunctival autografting and subconjunctival steroid injection. He was subsequently given 0.1 mL of 0.02% MMC as a subpterygial injection; one month later he had an alcohol-assisted bare sclera pterygium excision and a symblepharolysis with the intraoperative application of 0.02% MMC for 1 minute to the upper conjunctival fornix. Except for a Tenon granuloma that was simply excised, there has been no recurrence or other complications up to a year after surgery. Conclusion: As a cheaper and technically easier treatment option, a preoperative subconjunctival MMC injection followed by bare sclera pterygium excision was found to be effective in this patient with a recurrent pterygium. As at one-year follow-up, low-dose preoperative MMC a month prior to surgery also appeared safe and effective when combined with its intraoperative application to the conjunctival fornix for the treatment of associated symblepharon.
Pre- and intraoperative mitomycin C for recurrent pterygium associated with symblepharon  [cached]
Mohammed I
Clinical Ophthalmology , 2013,
Abstract: Isyaku MohammedDepartment of Ophthalmology, Aminu Kano Teaching Hospital, Kano, NigeriaBackground: Treatment of recurrent pterygium associated with symblepharon usually involves the use of tissue grafting and/or the intraoperative application of mitomycin C (MMC). For the graft, a conjunctival/limbal autograft and/or amniotic membrane may be used. This generally requires extra technical skills and assistance, an increase in the cost and duration of surgery, and a more extensive anesthesia (a complete eye block or general anesthesia). Although widely used, safety concerns have been raised over MMC in the treatment of pterygia.Objective: The objective of this case report is to report the successful use of preoperative subconjunctival injection of low-dose (0.02%) MMC one month before bare sclera excision of a multirecurrent pterygium, as well as the concomitant intraoperative application of MMC to the conjunctival fornix of the same eye after the excision of an associated symblepharon.Case report: A 31-year-old man from Kano, Northern Nigeria, presented to the eye clinic with a recurrent pterygium associated with an upper lid symblepharon in his right eye. He has had five previous pterygium excisions, with the last surgery involving conjunctival autografting and subconjunctival steroid injection. He was subsequently given 0.1 mL of 0.02% MMC as a subpterygial injection; one month later he had an alcohol-assisted bare sclera pterygium excision and a symblepharolysis with the intraoperative application of 0.02% MMC for 1 minute to the upper conjunctival fornix. Except for a Tenon granuloma that was simply excised, there has been no recurrence or other complications up to a year after surgery.Conclusion: As a cheaper and technically easier treatment option, a preoperative subconjunctival MMC injection followed by bare sclera pterygium excision was found to be effective in this patient with a recurrent pterygium. As at one-year follow-up, low-dose preoperative MMC a month prior to surgery also appeared safe and effective when combined with its intraoperative application to the conjunctival fornix for the treatment of associated symblepharon.Keywords: mitomycin C, pterygium, recurrence, symblepharon
Amniotic Membrane Transplantation for Primary Pterygium Surgery  [cached]
Asadollah Katbaab,Hamid-Reza Anvari Ardekani,Hamid Khoshniyat,Hamid-Reza Jahadi Hosseini
Journal of Ophthalmic & Vision Research , 2008,
Abstract: PURPOSE: To evaluate the outcomes of primary pterygium excision with adjunctive amniotic membrane transplantation. METHODS: In an interventional case series, consecutive patients with primary pterygia underwent surgical excision with transplantation of preserved amniotic membrane onto bare sclera. Patients were followed for at least 12 months and the results were evaluated in terms of recurrent pterygium growth and complications. RESULTS: Fifty eyes of 50 consecutive patients including 27 male and 23 female subjects with mean age of 43.36±10.88 years were operated. The pterygia extended onto the corneas for 4.69±1.2 (range 3 to 7) mm. Only one eye (2%) demonstrated recurrent pterygium growth which responded to subconjunctival mitomycin C injection. Another eye (2%) developed amniotic membrane retraction which eventually required a second transplantation leading to complete resolution. CONCLUSION: Primary pterygium excision with amniotic membrane transplantation is a safe and effective surgical technique with low recurrence rate.
The effect of topical 0.05% cyclosporine on recurrence following pterygium surgery  [cached]
Turan-Vural E,Torun-Acar BT,Kivanc SA,Acar S
Clinical Ophthalmology , 2011,
Abstract: Ece Turan-Vural1, Banu Torun-Acar1, S Argun Kivanc2, Suphi Acar11Haydarpa a Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey; 2Umran ye Education and Research Hospital, Ophthalmology Clinic, Istanbul, TurkeyPurpose: To investigate the role of postoperative topical 0.05% cyclosporine A (CsA) eye drops (Restasis , Allergan Pharmaceutical) in the prevention of recurrence among patients with primary pterygium treated with bare-sclera technique.Methods: In this prospective randomized controlled study, 36 eyes (34 patients) with primary pterygium were randomized into two groups: Group I comprised 18 eyes (18 patients), and Group II comprised 18 eyes (16 patients). Bare sclera technique was performed in both groups. In Group I, 0.05% CsA was administered postoperatively at 6-hour intervals for 6 months, and Group II did not receive any cyclosporine treatment. The patients were assessed for recurrence, side effects, and complications at postoperative 1 and 7 days as well as each month during the following year. Conjunctival advances which showed a limbus higher than 1 mm were recognized as recurrence.Results: Recurrence occurred in four patients (22.2%) in Group I and in eight (44.4%) patients in Group II.Conclusion: Postoperative application of low-dose CsA can be effective for preventing recurrences after primary pterygium surgery.Keywords: primary pterygium, cyclosporine A, bare sclera
Results of conjunctival autograft in pterygium surgery in Lumbini Eye Instititue, Nepal  [PDF]
K Dhakhwa,S Patel,MK Sharma,SKC Rai,AM Bhari
Journal of Universal College of Medical Sciences , 2014, DOI: 10.3126/jucms.v2i1.10482
Abstract: BACKGROUND: A pterygium is a wedge shaped fibrovascular growth of conjunctiva that extends onto the cornea. Various surgical techniques are used to treat this condition. Conjunctival graft over the bare sclera is one of the techniques used. The present study was done to evaluate the efficacy of autologous conjunctival graft in surgical management of primary and recurrent pterygium. MATERIALS AND METHODS: All the patients who underwent conjunctival autograft surgery for primary and recurrentpterygium from 1st Jan. 2010 to 30th June 2010 were enrolled prospectively. Follow up was done for six months after the surgery. RESULTS: A total of240 patients operated for primary and recurrent pterygium were enrolled in this study. There were 107 (44.6%) male and 133 (55.4%) female with male to female ratio 1: 1.3. Patients' age ranged from 15 to 80 years. Recurrences occurred in 3 ( 1.25%) cases. CONCLUSIONS: Free conjunctival autograft is a safe and effective procedure for prevention of recurrence in pterygium surgery. DOI: http://dx.doi.org/10.3126/jucms.v2i1.10482 ? Journal of Universal College of Medical Sciences (2014) Vol.2(1): 2-6
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