scholarly journals Limbal-conjunctival Autograft Transplantation Versus Conjunctival Autograft Transplantation In The Treatment Of Pterygium: A Self-control Study

2019 ◽  
Author(s):  
Tianyu Wang ◽  
Yifan Gu ◽  
Yi Zhang ◽  
Lu Pan
Keyword(s):  
Recurrence Rate ◽  
Healing Time ◽  
Corneal Epithelial ◽  
Conjunctival Autograft ◽  
Surgical Methods ◽  
Group A ◽  
Group B ◽  
Epithelial Healing ◽  
Limbal Conjunctival Autograft ◽  
Primary Pterygium

Abstract Background : Pterygium is a common ocular growth, which affects vision, ocular surface function, and aesthetics of the eye. Although various surgical methods are used for treating pterygium, there has been no consensus on the most suitable method. Therefore, it is important to choose the most appropriate and effective surgical method for the treatment of pterygium. The aim of this study was to compare the characteristics and efficacy of limbal-conjunctical autograft transplantation and conjunctival autograft transplantation for the treatment of pterygium. Methods : From August 2015 to December 2016, 80 patients with bilateral primary pterygium in Minhang Hospital affiliated to Fudan University were treated with limbal-conjunctival autograft transplantation in one eye (group A) and conjunctival autograft transplantation in the fellow eye (group B). The operative times of the two surgical methods were compared. The corneal epithelial healing times and recurrence rates for the two methods were observed and recorded after two years of follow-up. Results : Eight patients dropped out of the study and 72 patients participated in the final evaluation. The average operative time for group A and group B was 27.56 1.48 minutes and 26.91 1.39 minutes, respectively. There was no significant difference between the operative times for the two groups (t = 1.93, P = 0.058). The average corneal epithelial healing time for groups A and B was 2.56 0.34 days and 4.85 0.49 days, respectively (t=25.26, P < 0.001). Two years after the surgery, pterygium recurred in two eyes (2.78%) in group A and in nine eyes (14.29%) in group B. The difference between the two groups was statistically significant (2=4.82, P=0.028). Conclusion : In primary pterygium surgery, the healing time of the corneal epithelium after limbal-conjunctival autograft transplantation is shorter than that after conjunctival autograft transplantation, and the pterygium recurrence rate after limbal-conjunctival autograft transplantation is lower than that after autologous conjunctival transplantation. Although both limbal-conjunctival autograft transplantation and conjunctival autograft transplantation can achieve good clinical results, limbal-conjunctival autograft transplantation is superior to conjunctival autograft transplantation in terms of the corneal epithelial healing time and recurrence rate of pterygium after surgery.

scholarly journals Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study

2021 ◽  
Vol 14 (1) ◽  
pp. 82-87
Author(s):  
Khalil M. Al-Salem ◽  
Ahmad T.S. Saif ◽  
Passant S. Saif
Keyword(s):  
Postoperative Complications ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
University Hospital ◽  
Beta Radiation ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Excision ◽  
Group B ◽  
Primary Pterygium

Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

2021 ◽  
Vol 2 (3) ◽  
pp. 123-126
Author(s):  
Tian-Yu Wang ◽  
◽  
Min Yang ◽  
Yi Zhang ◽  
Zhao-Yang Wang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Case Series ◽  
Operation Time ◽  
Recurrence Time ◽  
Conjunctival Autograft ◽  
Long Term Follow Up ◽  
Pterygium Surgery ◽  
Limbal Conjunctival Autograft ◽  
Primary Pterygium

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

scholarly journals Membrane of Plasma Rich in Growth Factors in Primary Pterygium Surgery Compared to Amniotic Membrane Transplantation and Conjunctival Autograft

2021 ◽  
Vol 10 (23) ◽  
pp. 5711
Author(s):  
Miriam Idoipe ◽  
Borja de la Sen-Corcuera ◽  
Ronald M. Sánchez-Ávila ◽  
Carmen Sánchez-Pérez ◽  
María Satué ◽  
...  
Keyword(s):  
Growth Factors ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Amniotic Membrane Transplantation ◽  
Graft Size ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Surgery ◽  
Group B ◽  
Primary Pterygium

This prospective and comparative study aimed to compare the use of a conjunctival autograft (CAG), plasma rich in growth factors fibrin membrane (mPRGF) or amniotic membrane transplantation (AMT) in primary pterygium surgery. Patients were assigned for surgery with CAG (group A), mPRGF (group B), or AMT (group C). Pterygium recurrence, Best Corrected Visual Acuity (BCVA), graft size (measured with anterior segment optical coherence tomography (AS-OCT)), and ocular surface symptoms (visual analogue scale (VAS) and ocular surface disease index (OSDI)) were evaluated. Thirteen eyes in group A, 26 in group B, and 10 in group C were evaluated. No changes in BCVA (p > 0.05) were found. Recurrence cases for groups A, B, and C were none, two, and two, respectively, and three cases of pyogenic granulomas in group A. The horizontal/vertical graft size was lower in group B vs group A (p < 0.05) from months 1 to 12. The improvement in VAS frequency for groups A, B, and C was: 35.5%, 86.2%, and 39.1%, respectively. The OSDI scale reduction for groups A, B, and C was: 12.7%, 39.0%, and 84.1%. The use of the three surgical techniques as a graft for primary pterygium surgery was safe and effective, showing similar results. The mPRGF graft represents an autologous novel approach for pterygium surgery.

scholarly journals Complications and Recurrence after Pterygium Excision using Mitomycin C Eye Drops versus Sutureless and Glue Free Conjunctival Autograft: A Prospective Study

2020 ◽  
Author(s):  
Prachi Shukla ◽  
Suman Bhartiya
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Eye Drops ◽  
Conjunctival Autograft ◽  
Group A ◽  
Pterygium Excision ◽  
The Difference ◽  
One Year ◽  
Group B

Introduction: Recurrence is the most common problem with pterygium excision. Various adjunctive methods have been described to decrease the recurrence rate of pterygium. Mitomycin C (MMC) and limbal Conjunctival Autograft (CAG) are most commonly used methods to reduce its recurrence. Aim: To compare the recurrence rate of pterygium and the complications with MMC eyedrops after bare sclera pterygium excision versus sutureless and glue free CAG. Materials and Methods: Total 104 eyes were divided into two groups (A and B) of 52 eyes each. Group A patients underwent bare sclera excision of pterygium followed by 0.01% MMC eye drops BD (twice a day) for five days and Group B patients had sutureless and glue free CAG using oozing blood as tissue adhesive after pterygium excision. The patients were followed-up postoperatively on day 1, day 3, day 7, one month, three months, six months and one year. All the patients were examined for recurrence and complications. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 16 and student’s t-test was applied for comparison. Results: A total of 104 eyes of 92 patients were divided into two groups (A and B) of 52 each. The mean age of Group A was around 45 year and group B was around 43 years and the difference was statistically insignificant (p>0.05). Total three patients had recurrence in one year of follow-up in group A, out of which first case appeared before the end of 1st month, second before the completion of 3rd month and the third case at the last follow-up. In group B only one case presented with recurrence at 6th month follow-up. The difference between the recurrences in both the groups was statistically insignificant (p>0.05). Short term complications were observed in five patients in group A. One patient had corneal thinning; one had scleral thinning, two patients presented with avascular sclera and one patient with granuloma. In group B, 18 patients with graft retraction, eight with graft oedema, five with sub-conjunctival graft haemorrhage and one with granuloma were observed. All these complications resolved by the time. Long term complications were not observed in any patient of both the groups. Conclusion: This study concluded that the use of MMC eye drops (0.01%) BD or glue free and sutureless CAG after pterygium excision is safe and effective treatment modalities for pterygium.

scholarly journals OUTCOME OF AUTOLOGOUS LIMBAL CONJUNCTIVAL TRANSPLANTATION IN TERMS OF RECURRENCE RATE, AS THE MAIN OUTCOME MEASURE AND COMPLICATIONS AS THE SECONDARY OUTCOME

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr Rishi Gupta
Keyword(s):  
Recurrence Rate ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Care Hospital ◽  
Eye Care ◽  
Main Outcome Measure ◽  
Conjunctival Autograft ◽  
Pterygium Excision ◽  
Limbal Conjunctival Autograft ◽  
Primary Pterygium

Purpose: To find the outcome of autologous limbal conjunctival transplantation in terms of recurrence rate, as the main outcome measure and complications as the secondary outcome. Methods: The present study retrospective study conducted from a tertiary eye care hospital. Pterygium excision with limbal conjunctival autograft from the affected eye was performed for primary pterygium. Secondary pterygia resulting from inflammation, trauma and other diseases were excluded. Patients were followed up for 18 months for recurrence and other complications. Results: A total of 36 eyes of 36 patients with primary pterygia from November 2016 and October 2017 were included in the study. The study recruited 19 (52.7%) males and 17 (47.2%) females with mean age of 38.2 ±10.42 years. Pterygium was diagnosed more commonly in left eye(55.5%)  as compare to right eye(44.4%). Out of 36 cases 32 (88.8%) cases of  nasal and 4 (11.1%) cases of temporal pterygium noted. Out of 36 cases Graft edema in 1 (2.7%) case, graft retraction in 2 (5.5%) cases and 1 (2.7%) case of granuloma were noted. Any kind of pterygium recurrence and graft necrosis was not noted in present study. Conclusions: Pterygium excision with autologous limbal conjunctival autograft is safe and effective method to treat primary pterygium.

COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shrikant . ◽  
R.D. Mehta ◽  
B.C. Ghiya
Keyword(s):  
Partial Response ◽  
Comparative Study ◽  
Recurrence Rate ◽  
Vitamin D3 ◽  
Complete Response ◽  
Recurrence Rates ◽  
Additional Advantage ◽  
Cost Effective Treatment ◽  
Group A ◽  
Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

scholarly journals Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash
Keyword(s):  
Recurrence Rate ◽  
Corticosteroid Therapy ◽  
Surgical Excision ◽  
Cosmetic Outcome ◽  
Systemic Steroid ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Palpable Mass ◽  
Group A ◽  
Group B

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

Comparison of 4 Techniques for Limbal-Conjunctival Autograft Fixation in Primary Pterygium Surgery

2017 ◽  
Vol 27 (4) ◽  
pp. 466-469 ◽  
Author(s):  
Luis F. Mejía ◽  
Juan P. Santamaría ◽  
Miguel Cuevas ◽  
Andrea Córdoba ◽  
Sergio A. Carvajal
Keyword(s):  
Recurrence Rate ◽  
Fibrin Glue ◽  
Ocular Inflammation ◽  
Postoperative Patient ◽  
Patient Discomfort ◽  
Conjunctival Autograft ◽  
Significant Difference ◽  
Fixation Techniques ◽  
Pterygium Surgery ◽  
Limbal Conjunctival Autograft

Purpose To compare 4 limbal-conjunctival autograft fixation techniques—conventional suture, commercial fibrin glue, autologous fibrin glue, and cautery—in primary nasal pterygium surgery. Methods This is a retrospective and descriptive study. The postoperative patient discomfort, graft edema, ocular inflammation, and other complications of 4 limbal-conjunctival autograft fixation techniques in primary nasal pterygium surgery were evaluated. Results Postoperative patient discomfort was significantly lower with the sutureless techniques (p<0.001), with fixation with cautery having the lowest rate of discomfort. Graft edema and ocular inflammation during the early postoperative period were significantly higher when fibrin glue techniques were used (p<0.001). The recurrence rate did not show a statistically significant difference (p = 0.682) among the 4 groups. Conclusion In primary nasal pterygium surgery, limbal-conjunctival autograft fixation using cautery is the technique with the lowest postoperative discomfort rate and without a statistically significant increase in recurrence rate when compared to conventional suture and fibrin glue techniques.

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