complications of pterygium

Kaufman S.C., Jacobs D.S., Lee W.B., Deng S.X., Rosenblatt M.I., Shtein R.M. Yeung SN et al. Most of the immediate postoperative complications of pterygium surgery are not vision-threatening and resolve rapidly. He was a field worker, smoker and had a family history of pterygium. Excess scarring can occasionally cause restrictive strabismus. Pterygium: Causes, Symptoms and Diagnosis - Healthline While excising the pterygium, the surgeon can inadvertently excise the underlying scleral lamella also. Different surgical techniques for double-headed pterygium have been performed [3, 4]. Song Y.W., Yu A.H., Cai X.J. The patients were followed at day 1, 2 weeks, 6 weeks, 6 months initially after the surgery, then every 6 months thereafter. In total we performed this technique in 92 patients and did not detect a serious sight-threatening problem at a minimum 1 year follow up time. In the present study, we have used fibrin glue in all the cases and did not find any disadvantage over sutures. Veluri H, Alla S, Potti S, Khatib NL Long term follow up results of, 19. 13.2Conjunctiva receded in the immediate postoperative period. Demographic data, number, types of pterygia included in the study, and the follow-up period is shown in Table 1. Graft dehiscence was diagnosed in 7 Multi-layer amniotic membrane graft for pterygium in a patient with xeroderma pigmentosum. [26] demonstrated that family history of pterygium and blepharitis found to be risk factors. Goyal JL, Rao VA, Srinivasan R, Agrawal K. Oculocutaneous manifestations in xeroderma pigmentosa. One of the major limitations of pterygium excision is the high rate of postoperative recurrence. Here, the greater protrusion was not seen and there was no advanced form of pterygium in our patient. The possible reasons for the poor adhesion are due to improper application of tissue glue or sutures. -. Temporal pterygium was larger and excised firstly. Chen T, Ding L, Shan G, Ke L, Ma J, Zhong Y. Maharshak I, Avisar R. Bilateral primary pterygia: an occupational disease? Yksel B., Unsal S.K., Onat S. Comparison of fibrin glue and suture technique in pterygium surgery performed with limbal autograft. Pterygium - StatPearls - NCBI Bookshelf - National Center for An effective surgical regime of pterygium surgery is presented. Conjunctiva should cover the sclera up to the limbus and thereby preventing migration of MMC. government site. This drug is referred to as radio-mimetic as its action mimics that of ionizing radiation. Future studies with meticulous genetic mutation analysis and longer follow-up are recommended. 5 Conjunctival autograft with pterygium excision is known to show less recurrence and is the first choice of surgical treatment. Dividing the free conjunctival autograft into two parts and suturing in place of the excised pterygium on both side of the corneas seems to be a good choice in double headed pterygium [3]. If the excised layer is thin, it will not cause significant problems postoperatively. An official website of the United States government. BMC Ophthalmol. In graft transplantation, fibrin glue shortens the operation time and enhances the post-operative comfort, compared with the use of sutures [8-1]. 1972 Jan;56(1):52-6 Appearance is at sixth month after the surgery. The following postoperative complications were noted in these 2356 cases. sharing sensitive information, make sure youre on a federal Two of them regressed after stopping of topical steroids and continuing with only lubricant therapy and one was treated with amniotic membrane transplantation. Our hypothesis was that MMC used on the bulbar conjunctiva after pterygium . 13 Hence, it is recommended that only high-risk pterygia should receive MMC. 1d] was seen in 9 cases (0.38%). The conjunctiva. L P., Chen X.M. Kodavoor, Shreesha K; V, Preethi; Dandapani, Ramamurthy1, Department of Cornea and Phacorefractive, The Eye Foundation, Coimbatore, Tamil Nadu, India, 1Department of Cataract and Refractive, The Eye Foundation, Coimbatore, Tamil Nadu, India, Correspondence to: Dr. Shreesha Kumar Kodavoor, The Eye Foundation, Department of Cornea and Phacorefractive, Diwan Bahadur Road, RS Puram, West Coimbatore, Tamil Nadu - 641 002, India. In this manuscript, an interesting rare case of a bilateral double-headed recurrent pterygium and vertical split conjunctival autograft transplantation (CAT) simultaneous surgery (to both nasal and temporal parts of the right eye) was presented. Protocol 2 has shown to have higher compliance rate than protocol 1 and less postoperative complications, proving to be a safe and effective postoperative treatment after pterygium surgery. modify the keyword list to augment your search. Accordingly, they asserted that fibrin glue may be used instead of sutures in conjunctiva autografts as a method that shortens operation time and causes less discomfort in the postoperative period. The conjunctival graft was taken from the superior conjunctiva. recently reviewed the records of 20 eyes of 18 patients who applied to their clinic for non-recurrent complications of pterygium surgery [12]. Malekifar P, Esfandiari H, Behnaz N, Javadi F, Azish S, Javadi MA, et al. after cessation of topical steroids and application of lubricant therapy while one was treated with amniotic membrane Malekifar P et al. The age of the patients at treatment ranged from 27 to 69 years (mean 48 +/- 11), and complications were assessed 3 to 20 years later (mean 12 +/- 3). He was satisfied with his right eye and demanded the same surgery for his left eye. 17. The study was approved by the institutional ethics committee and adhered to the tenets of the Declaration of Helsinki. Pterygium - Symptoms, Causes, Images, and Treatment Options - Epocrates Web It would take time to recovery and he did not want to waste time for each surgery for both eyes. 2021 Aug 27;51(4):192-198. doi: 10.4274/tjo.galenos.2020.27116. Non-Recurrence Complications of Fibrin Glue Use in Pterygium Surgery Those grafts were carefully placed on the bare sclera and attached with the fibrin glue without displacing the torn edge. A successful pterygium excision was performed under local anesthesia with the vertical split conjunctival autograft transplantation (CAT) in both temporal and nasal parts of the right eye (randomly) for cosmetic disfigurement and avoidance of recurrence. Koranyi G., Seregard S., Kopp E.D. Excessive bleeding can occur in highly vascularized thick pterygium. Alaniz-Camino F The use of postoperative beta radiation in the treatment of pterygia Ophthalmic Surg 1982 13 1022 5, 11. Pterygium in Indonesia: prevalence, severity and risk factors. to maintaining your privacy and will not share your personal information without Wolters Kluwer Health Increased fibroblastic activity is a well-established finding in recurrent pterygia. avoid potential complications of fibrin glue in pterygium surgery, peroperatively ophthalmologists should ensure the The aim of an ideal pterygium surgery is the prevention of recurrence, which is the most common complication. 10. Would you like email updates of new search results? Abstract. CAT is . He had no history of any ocular surgery except for pterygium surgery 15 years ago in both eyes. Ugurba S.H., Karg ., Alpay A., Gney T. Sutureless conjunctival autograft in pterygium treatment. Corneal dellen developed in 3 (3.26%) patients and 2 of them regressed Some error has occurred while processing your request. Pterygium among Latino migrant farmworkers in North Carolina. Effectiveness of amniotic membrane transplantation combined with mitomycin C in the treatment of pterygium: a meta-analysis. Huerva V, March A, Martinez-Alonso M, Muniesa MJ, Sanchez C. Pterygium surgery by means of conjunctival autograft: long term follow-up. Complications; conjunctival autograft; conjunctival limbal autograft; pterygium. [27] mentioned a strong association between dry eye and pterygium. Kodavoor SK, Tiwari NN, Ramamurthy D Long-term analysis of an unconventional way of doing double-head, 27. Inclusion in an NLM database does not imply endorsement of, or agreement with, [Pterygoid corneal dystrophy]. If pterygium grows, your vision may be blocked or blurred. 7 Topical bevacizumab (5 mg/mL) twice a day has shown to delay the recurrence in impending recurrent pterygia. You may search for similar articles that contain these same keywords or you may In such cases, scar exploration and release of fibrosis are usually performed. MeSH The graft was fixed using fibrin glue, Tisseel (Baxter, Vienna, Austria). The complications post pterygium excision and auto-grafting include subconjunctival hemorrhage, graft edema, graft loss, retraction, graft sliding, granuloma, and recurrence. Radiation induced cataract occurred in 3 eyes, with reduced vision. Yalcin Tok O, Burcu Nurozler A, Ergun G, Akbas Kocaoglu F, Duman S. Topical cyclosporine A in the prevention of pterygium recurrence. One of the main complications of pterygium surgery is recurrence, in our study the total recurrence rate was 1.44%. There were no intraoperative and postoperative complications and concluded that the 180-degree CRA technique was effective and safe in preventing the recurrence of primary pterygium. The nasal half was released from its base and placed over the nasal bare sclera without changing the orientation. A procedure Marticorena J, Rodrguez-Ares MT, Tourio R, Mera P, Valladares MJ, Martinez-de-la-Casa JM, et al. Cagatay H.H., Gokce G., Ekinci M., Koban Y., Daraman O., Ceylan E. Long-term comparison of fibrin tissue glue and vicryl suture in conjunctival autografting for pterygium surgery. Graft edema may be seen in the early postoperative period; however, it resolves with topical treatment. 2 Pterygium is an enigma and many theories have been . Hemorrhage can also happen in inflamed pterygium; therefore, inflamed pterygium has to be controlled by anti-inflammatory agents or low potent steroid before surgery. Before Disclaimer. Results: The following postoperative complications were noted, Sub-conjunctival hemorrhage in 912 eyes (38.7%), edema of the graft in 522 cases (22.15%), graft loss in 22 cases (0.93%), graft retraction in 692 cases (29.37%) and sliding of the graft was seen in 9 cases (0.38%). Additionally they compared the non-recurrent complications and at 6th month follow up visit, they detected non-recurrent complications including pyogenic granuloma in 4 patients (16.7%), graft dehiscence in 3 patients (12.5%) and conjunctival contraction in three patients (12.5%) in the conjunctival autograft transplantation group with a similar rate in the amniotic membrane transplantation group. Although fibrin glue is a material that shortens operation time, improves postoperative patient comfort and decreases inflammation, patients should be carefully followed in the postoperative time period for any possible complications. official website and that any information you provide is encrypted 1968;176(2):100-25 Duman F, Kosker M. Demographics of Patients with Double-headed Pterygium and Surgical Outcomes. government site. The conjunctiva may recede in the early postoperative period and expose the underlying sclera ( Fig. A pterygium is a fibrovascular tissue that often originates from the nasal bulbar conjunctiva and extends onto the cornea in a wing shape. These cysts were primarily excised in the examination room, and no additional problems occurred. Federal government websites often end in .gov or .mil. Multi-layer amniotic membrane graft for pterygium was also mentioned [31]. 2022 Mar;70(3):783-787. doi: 10.4103/ijo.IJO_1895_21. Learn more from epocrates about Pterygium, including symptoms, causes, differential diagnosis, and treatment options Pterygium - Symptoms, Causes, Images, and Treatment Options Funding/Support: None. Background: The use of topical mitomycin (mitomycin-C) as a medical adjunct to pterygium and glaucoma surgery is increasing.Methods: The authors report on a series of 10 patients who experienced serious, vision-threatening complications associated with the use of this drug after pterygium surgery.Results: Complications included severe secondary glaucoma (4 patients), corneal edema (3 patients . The temporal half of the graft was placed on the temporal bare sclera. Schirmer test was also applied and both eye values were 30 mm. our patient had a bilateral pterygium and did not have amblyopia or eccentric fixation. Janson BJ, Sikder S. Surgical management of pterygium. 14 Scleral thinning with perforation can also happen as a late complication. Conjunctival chemosis can be seen in few patients which resolves spontaneously. conjunctival autograft and conjunctiva are properly adhered, fibrin glue remnants are completely removed from the ocular The recurrence rate was 10.9% (primary), 37.5% (recurrence), and 14.8% (all pterygium) after pterygium excision with amniotic membrane graft in a study by Prabhasawat et al. These complications include increased conjunctival inflammation, giant papillary conjunctivitis, corneal ulcer, conjunctival granuloma and abscess. Arrows show conjunctival autografts in place, Slit-lamp photograph of the patients right eye at the postoperative 1.5-month, showing fine corneal opacity in nasal and temporal sides of peripheral cornea. irritation in one (1.08%) patient on the same day of the surgery. Pterygium formation was found strongly associated with its location and laterality [36]. 12 Complications including temporary and prolonged discomfort, tearing, hyperemia, subconjunctival hemorrhage, wound dehiscence, and pigment accumulation were also noted with a single dose of intraoperative MMC by Anduze and Burnett. In addition, in cases where graft fixation is accomplished with sutures, events such as decreased patient comfort, symblepharon and graft laceration have been reported [18]. Subconjunctival hemorrhage was seen in 722 cases (34.29%) in primary pterygium and 190 cases (75.69%) of recurrent pterygium with a significant P < 0.000001. Pterygium is also known as Surfer's Eye. Currently, the most common methods include the bare sclera technique, primary conjunctival closure, conjunctival autograft transplantation with or without limbal cells, surface reconstruction with amnion membrane and use of antimetabolites [3, 4, 12]. Gris O, Gell JL, del Campo Z Limbal-, 22. Radiation damage after pterygium treatment. Pterygium excision with conjunctival autograft is a widely performed surgery for pterygium. Tel: +905062358670, E-mail: becekurtul@yahoo.com, This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (. Beijing Eye Public Health Care Project. The https:// ensures that you are connecting to the Adjuvants like Mitomycin C,[9] beta-irradiation,[10] 5-florouracil,[11] have been used along with pterygium excision to reduce the recurrences. Perfect pterygium surgery should achieve a low or no recurrence rate, negligible complications and good cosmetic outcome [3, 4]. This growth covers the white part of the eye (sclera) and extends onto the cornea. Graft retraction was seen in 620 cases (29.45%) and 72 cases (28.6%) in primary and recurrent pterygium respectively, with no significant P value (P = 0.857). Mitomycin C for pterygium: long term evaluation - PMC The only complication was mild conjunctival avascularity in areas of pterygium excision in 30% of patients. 9, MMC is an antimetabolite agent produced by a strain of Streptomyces caespitosus. In the group where fibrin glue was used, granuloma occurred more frequently (3 patients) and regressed upon medical therapy in two patients, whereas in one case it was treated with granuloma excision and amniotic membrane transplantation. Besherati et al, compared the amniotic membrane transplantation with conjunctival autograft transplantation using 8-0 vicryl and reported an unacceptably high recurrence rate in amniotic membrane group [17]. 2016 Feb 11;2(2):CD011349. Deeplamellar keratoplasty with conjunctival autograft for recurrent advanced pterygium correlated with corneal thinning was mentioned [35]. Pterygium: an update on pathophysiology, clinical features, and A literature review was performed based on the results yielded from searching PubMed, Embase, Web of Science, Scopus, and Cochrane database using the follow-ing keywords: pterygium, complications, etiolo- Search for Similar Articles It has been reported that it is due to the drugs effect on multipotential cells and the rapidly proliferating cells of vascular endothelium. Pterygium: an update on pathophysiology, clinical features, and Molho-Pessach V, Mechoulam H, Siam R, Babay S, Ramot Y, Zlotogorski A. Ophthalmologic Findings in H Syndrome: A Unique Diagnostic Clue. Prevalence and racial differences in pterygium: a cross-sectional study in Han and Uygur adults in Xinjiang, China. Bethesda, MD 20894, Web Policies

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