Affiliation:
1. M
2. MGM Medical College, Indore, Madhya Pradesh, India
Abstract
Recurrence is a significant problem after pterygium excision. Therefore in this study its risk factors and management is discussed. This study was conducted to observe recurrence after conjunctival limbal autograft (CLAU) & to evaluate different factors related with recurrence of pterygium and assessing its different management methods. Hundred & seven patients with primary pterygium were examined, excised by CLAU and histopathology sample sent. The outcomes were assessed in terms of clinically significant recurrence till 6 months follow-up. Early topical mitomycin-C (MMC) 0.02% QID for a week was given to avoid resurgence of clinically significant pterygium, however if developed then excised by CLAU (if <4mm) or AMG (Amniotic membrane grafting) (if > 4mm). Out of total cases, 57% were females. Histopathology findings includeEpithelial Hyperplasia (80.4%), vascularity overwhelms fibrosis (39.1%), vascularity similar to fibrosis (28.3%), fibrosis overwhelms vascularity (34.8%), perivascular stromal inflammation (54.3%), diffuse stromal inflammation (37.0%). The following variables were significantly associated (p<0.05) with the recurrence: age, redness & thickness, higher vascularity, diffuse inflammation. Factors such as younger age group, higher redness and thickness of pterygium, more vascularity, and diffuse inflammation on histopathological examination can be considered as a risk factor for recurrence. However, occupation, location, and type of pterygium were found not to be related to recurrence. Although no clinically significant recurrence was seen after mitomycin c eyedrops, but no significant correlation can be made. Young patients having pre-operative features like red and fleshy pterygium, along with vascularity more than fibrosis and diffuse inflammation on histopathological examination should be followed strictly and managed intensely.
Publisher
IP Innovative Publication Pvt Ltd
Reference20 articles.
1. Coster D, Pterygium - An ophthalmic enigma.Br J Ophthalmol 1995;79:304-5
2. Girolamo ND, Chui J, Coroneo MT, Wakefield D, Pathogenesis of pterygia: role of cytokines, growth factors, and matrix metalloproteinases.Prog Retin Eye Res 2004;23(2):195-228
3. Li DQ, Lee S B, Gunja-Smith Z, Liu Y, Solomon A, Meller D, Overexpression of collagenase (MMP-1) and stromelysin (MMP-3) by pterygium head fibroblasts.Arch Ophthalmol 2001;119(1):71-80
4. Clearfield E, Hawkins BS, Kuo IC, Conjunctival autograft versus amniotic membrane transplantation for treatment of pterygium: findings from a Cochrane systematic review.Am J Ophthalmol 2017;182:8-17
5. Yaisawang S, Piyapattanakrn P, Role of postoperative topical corticosteroid in recurrence rate after pterygium excision with conjunctival autograft.J Med Assoc Thai 2003;86(Suppl 2):5215-23
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献