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mucormycosis (ROCM) is an acute, often fatal, fungal infection caused by members
of the class Zygomycetes and the order Mucorales. The genus Rhizopus accounts for most cases of ROCM.
The disease is characterized by fungal hyphal invasion of blood vessels resulting
in thrombosis and infarction of the nasal, paranasal sinus, orbital, and cerebral
tissues. The most commonly associated condition is diabetes mellitus; other associated
conditions include immunocompromised states, renal disease, deferoxamine use and
acidotic states. The most frequent sites of infection are pulmonary, rhinocerebral,
cutaneous and disseminated. Rhino-orbital and Rhino-cerebral are two forms of the disease. As such the condition is a medical emergency. Early
recognition and treatment are essential because it may lead to death in a few days.
CROP usually begins in the palate or paranasal sinuses and rapidly spreads to the
orbital contents. Proptosis, loss of vision and ophthalmoplegia occur and death
from cerebral involvement commonly ensues. The fungus tends to invade arteries and
cause thrombosis and tissue infarction. Rhizopus is the most commonly isolated genus in CROP, accounting for almost all cases. The
diagnosis can be strongly suspected by the characteristic clinical manifestations.
Therapy includes the treatment of the underlying disease, surgical excision of the
necrotic tissue containing fungal elements and the systemic administration of amphotericin-B.
Here we report the clinical features of a 32-years-old man presented mucormycosis.
Aim: To prospectively analyze the clinical
profile of pterygium and to compare results of management by excision with limbal
conjunctival autograft or postoperative topical Mitomycin C drops. Methodology: Study was conducted over a period of
23 months, at a tertiary eye care hospital including 80 eyes of 80 patients who
underwent surgery, out of which 40 underwent limbal conjunctival autograft and
the remaining 40 underwent pterygium excision followed by Mitomycin C after
fulfilling the inclusion criteria. A detailed history was taken and recorded
regarding the disease with reference to age, occupation, residence, exposure to
dust and hot wind. The extent of corneal involvement by the pterygium was
noted. The patients were followed after one week and then monthly for a year.
BCVA were noted on every visit and slit lamp examination was done for
recurrence, sclera thinning and corneal vascularisation. Result: 80 eyes of 80 patients were enrolled
with male preponderance, out of which 40 underwent limbal conjunctival
autograft (gr. A) and the remaining 40 underwent pterygium excision followed by
Mitomycin C (gr. B). All patients were in the age group of 23 to 70 years. The
study showed a higher incidence of pterygium in the age group of 41-50 years with male preponderance
probably due to chronic dryness, and exposure to ultraviolet light, dust, and
hot winds. The right eye was more affected than the left eye, and nasal side
was more involved than the temporal side. The recurrence among group A was 2
out of 40 with a recurrence rate of 5% and among group B was 3 out of 40 with a
recurrence rate of 7.5%. Scleral thinning was seen in two cases (5%) in
patients who underwent pterygium excision followed by Mitomycin C. Conclusion: Conjunctival limbal autograft and
postoperative MMC (0.02%) are both safe and effective adjuncts to primary
pterygium surgery. The main prejudices against autografting are the expertise