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.

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 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 The Role of Using Motorized Diamond Burr Polisher Instrument in Minimizing the Recurrent Rate of Pterygium Excision

2020 ◽  
pp. 129-136
Author(s):  
Sakar Abdulkarim Nidhamalddin
Keyword(s):  
Diamond Polishing ◽  
Corneal Scar ◽  
Group A ◽  
Iop Measurement ◽  
The Mean ◽  
Diamond Burr ◽  
Pterygium Excision ◽  
The Difference ◽  
Group B ◽  
Primary Pterygium

To compare the effects of using motorized diamond burr polisher in pterygium excision versus manual polishing of the corneoscleral bed in reducing the recurrent rate. A prospective, comparative and interventional study of 90 consecutive patients with different grads of primary pterygium, who underwent pterygium excision at Shahid Aso teaching eye hospital in Sulaimani city, between August 2018 till September 2019, which was performed by single surgeon. In group A (45) eyes polishing of the corneoscleral bed done using motorized diamond polishing burr, and in group B (45) eyes using manual crescent blade for polishing. Recurrent rate was evaluated after about (8±2) months postoperatively. Ethical consideration of the risks and the benefits of the procedure was observed for each individual patient. A 90 patients with the mean age of group A (48.84±12.7) years and group B (49.67±12.3) years, complained of different grads of primary pterygium, group A had 31(68.9%) male and 14(31.1%) female, while group B had 22(48.9%) male and 23(51.1%) female. Each individual factors like age, gender, visual acuity, BCVA pre and postoperatively, IOP measurement, dryness of the eye and risk factors like smoking and UV exposure affecting the recurrence were assessed. In both groups the main indication for surgery was sign of irritation. The mean surgical time was calculated and the difference between two groups were significant. After follow-up of average six months the outcomes and recurrent rate were checked, recurrent rate was in group A 1(2.2%) while in group B was 6(13.3%) patients. it significantly decreased. Corneal scar happens in only 1(2.2%) case of group A while in 11(24.4%) cases in group B, Corneal scar was statistically significant. In both groups the change of BCVA was significant but the visual change was more significant in group A in compare to group B. Motorized diamond burr is a safe instrument for polishing the cornea during pterygium excision, it is easy to handle, low price, need lesser operative time, its effect on recurrence postoperatively is significant and beside it leaves lesser corneal scar and early visual recovery postoperatively.   

scholarly journals Recurrence rate of superficial bladder cancer with intravesical BCG and mitomycin.

2021 ◽  
Vol 28 (06) ◽  
pp. 854-860
Author(s):  
Khalid Hussain ◽  
Muhammad Asif ◽  
Farooq Malik ◽  
Munazza Yasmeen ◽  
Maria Tariq ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
Superficial Bladder Cancer ◽  
Controlled Trial ◽  
Transitional Cell ◽  
Female Ratio ◽  
Intravesical Bcg ◽  
Group A ◽  
Group B

Objective: To compare the recurrence rate of superficial transitional cell carcinoma of urinary bladder using intravesical BCG and Mitomycin-C. Study Design: Randomized Controlled Trial. Setting: Urology Department, Teaching DHQ Hospital, Gujranwala. Period: November 2018, to Sep, 2019. Material & Methods: Was carried out on total 270 patients, admitted with suspicion of urothelial tumors. They were grouped in Group A and B, comprising 135 in each group. Group A received BCG and Group B received Mtiomycin-C intravesically following TUR-BT. Results: Out of 270 patients male to female ratio was 3:1. Age range of patients was between 30 to 70 years with mean of 50.0± 13.1 and 552.3 ± 12.9 years in Group A and B respectively. Recurrence was noted in 05.38% and 15.38% patients in Group A and B respectively. Regarding side effects pyrexia was associated with BCG in 27.40% patients which were self-limited in 26.66% cases however required anti-tuberculosis therapy for six months in 0.74%. Whereas only 06.67% patients receiving Mitomycin had pyrexia. Dysuria occurred in 74% and frequency in 68% patients who received BCG. Whereas Dysuria occurred in 20% and frequency in 36.29% patients who received Mitomycin-C. However genital skin rash was more common (08.14%) in Mitomycin group than BCG. Conclusion: Keeping in mind less recurrence rate and bearable toxicity, it is concluded that BCG is superior to Mitomycin. This study suggests long term follow up is required to establish recurrence in the management of superficial bladder cancer.

scholarly journals To Compare Frequency of Tumour Recurrence in Low Risk Transitional Cell Carcinoma of Bladder Between Single Dose Mitomycin C Instillation and Control Group

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Sanaullah . ◽  
Mumtaz Ali ◽  
Nizamuddin . ◽  
Fazal Elahi ◽  
Amanullah . ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
Transitional Cell ◽  
Low Risk ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Group A ◽  
Muscle Invasive ◽  
Group B

Background: Many regimes of intravesical therapy have been tried in attempt to reduce the recurrence rate of non muscle invasive bladder cancer, these generally require frequent attendance for instillation. Multiple non-comparative studies have demonstrated the favourable outcomes of the immediate treatment by instillation of mitomycin C after transurethral resection of bladder tumor (TURBT) in cases of non-muscle invasive Transitional Cell Carcinoma.Objective: To compare frequency of tumour recurrence in low risk transitional cell carcinoma of bladder between single dose Mitomycin C instillation and control group.Material and Methods: This study was conducted at urology departmentsaidu teaching hospital and Nawaz sharif kidney center swat. Study Design Quasi Experimental.Study Duration was (From: Feb 2018 to February 2019). Total 62 patients fulfilling the inclusion criteria were selected. Patient were divided between group A and B according to Non probability purposive sampling. TURBT was done in all patients. In those assigned to group A Mitomycin C 40mg was instilled through foleys catheter and clamped within 12 hrs of resection once haematuria has cleared. Mitomycin C was retained for 2 hrs and then foleys catheter was removed.Results: Mean age of patients in Group-A and in Group-B was 54.90±11.48 and 60.03±13.58 years respectively. In Group-A 1(3.2%) and in Group-B 9(29%) patients had recurrence after 3 months follow up time period. Recurrence rate of Group-B was significantly higher. i.e. (p-value=0.006).Conclusion: Results of this study showed the superiority of mitomycin C in patients with low risk non muscle invasive bladder cancer in terms of significantly lower recurrence rate as compared to that of control group. So, it can be said that single mitomycin C instillation significantly decrease recurrence in patients with low risk non muscle invasive bladder cancer.

scholarly journals Evaluation of Conjunctival Autografting Augmented with Mitomycin C Application versus Ologen Implantation in the Surgical Treatment of Recurrent Pterygium

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Faried M. Wagdy ◽  
Hassan G. Farahat ◽  
Amin F. Ellakwa ◽  
Sameh S. Mandour
Keyword(s):  
Postoperative Complications ◽  
Mitomycin C ◽  
University Hospital ◽  
Time Interval ◽  
Randomised Study ◽  
Significant Difference ◽  
Recurrent Pterygium ◽  
Group B ◽  
Conjunctival Autografting

Objectives. To evaluate the safety and efficacy of augmenting conjunctival autografting with intraoperative mitomycin C (MMC) application versus Ologen implantation in the management of recurrent pterygium. Materials and Methods. This prospective randomised study included 63 eyes of 63 patients, with recurrent nasal pterygium, who presented to the outpatient clinic of Menoufia University Hospital in Shebin El Kom and Manshiet Soltan from January 2016 to December 2019. Patients were randomly enrolled into two groups. Group A included 32 eyes of 32 patients who underwent conjunctival autografting augmented with the topical application of MMC (0.2 mg/mL), and group B included 31 eyes of 31 patients who underwent conjunctival autografting augmented with Ologen implantation. All the patients underwent follow-up examinations for a period of 24 months. During each visit, a complete ophthalmic examination was performed. Pterygium regrowth of 1 mm or more, over the cornea, was considered a recurrence. Results. In the MMC group, no recurrence was reported during the 24-month follow-up period. In the Ologen implantation group, recurrence was reported in 2 (8%) eyes. The time interval from surgery to recurrence was 5 months in one case and 8 months in the other. No other serious postoperative complications were reported, and there was no statistically significant difference between the groups in this regard. Conclusion. Ologen implantation with conjunctival autografting shows promising results in the surgical management of recurrent pterygium with mild non-vision-threatening postoperative complications comparable to that of MMC application with conjunctival autografting. Registration number: ClinicalTrials.govNCT04419038.

Acute hiatal hernias

2019 ◽  
Vol 98 (5) ◽  
pp. 207-213
Keyword(s):  
Postoperative Complications ◽  
Hiatal Hernia ◽  
Surgical Repair ◽  
Clinical Symptoms ◽  
University Hospital ◽  
Severe Bleeding ◽  
Large Hiatal Hernia ◽  
Preoperative Symptom ◽  
Group A ◽  
Group B

Introduction: In surgical practice, hiatal hernias are often related to gastro esophageal reflux disease treatment in which continuous proton pump inhibitor administration is very successful. In large hiatal hernias, life threatening complications may occur. However, planned surgical repair of hiatal hernias is associated with very good functional outcomes with a low risk of postoperative complications. The incidence of large hiatal hernias grows with increasing age of the patient. In geriatric patients, internal comorbidities are also more frequent, including serious conditions. In these patients, one may hesitate whether to perform surgery with regard to the possible risk of postoperative complications. Conservative treatment of hiatal hernias is associated with a higher risk of stomach volvulus or severe bleeding as the most frequent complications. Methods: We performed a retrospective study of patients operated on for a large hiatal hernia at the Department of Surgery, University Hospital Brno, between 2010 and 2016 (86 months). The patients were divided into 2 groups depending on the type of operation: acute (A) and elective (B). We evaluated demographic data, the nature of preoperative symptoms, type of surgery and postoperative complications. Results: 120 patients were operated on for large hiatal hernia in this period of time. Group A involved 22 operated patients, group B 98 patients. There was a significantly higher number of laparotomies in the acute patient group compared to the elective group B (72.7 % vs. 23.5%, p<0.0001). Average surgery duration was longer in group A than in group B (133.8 minutes vs. 109.8 minutes). Postoperative complications were significantly more frequent in group A. They were also more severe and combined in a single patient. One death occurred in group A, in group B no patient died. Preoperative symptom analysis revealed a statistically significantly higher incidence of vomiting and breathing difficulties in group A. In group B, regurgitation and pyrosis were present with a significantly higher frequency. Conclusion: In small hiatal hernias, the rate of complication occurrence is low. With growing size of the hernias, the risk of potentially life threaten- ing acute complication increases. Stomach volvulus and severe bleeding in particular are the most frequent complications of hiatal hernias. Acute operations are associated with a significantly higher risk of postoperative complications than elective procedures. Surgical repair of hiatal hernia should be indicated in all symptomatic patients with a large hiatal hernia. In patients without clinical symptoms, surgical repair of hernia is recom- mended if there are no significant internal contraindications to surgery.

scholarly journals Comparison of conjunctival free autograft and Rotational flap technique in primary pterygium surgery: Visual changes and safety profiles

2021 ◽  
Vol 6 (3) ◽  
pp. 50-55
Author(s):  
Dr. Pawan Chaurasia ◽  
◽  
Dr. Vaishali Chaurasia ◽  
Keyword(s):  
Visual Acuity ◽  
Patient’S Satisfaction ◽  
Conjunctival Autograft ◽  
Flap Technique ◽  
Rotational Flap ◽  
Group A ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Group B ◽  
Visual Changes

Aims and objectives: To evaluate the postoperative symptomatic comfort, visual changes,complication and rate of recurrence in free conjunctival autograft and rotational flap technique inprimary pterygium surgery. Materials & Methods: This prospective study was conducted in 60 eyesof 60 patients, presented with primary progressive nasal pterygium larger than 1mm causingsymptomatic discomfort, astigmatism and cosmetic disfigurement. Patients were divided into twogroups randomly. In group A, patients with pterygium excision with free conjunctival autograft andgroup B, pterygium excision with rotation flap technique were included. Post-operative day 1symptomatic comfort (symptoms and signs), graft stability, corneal clarity and any complicationwere noted. Visual acuity (VA), auto-refracto keratometer measurements and detailedbiomicroscopic examinations, were performed preoperatively and postoperatively at 1month and 3months. Results: Most of the patients in our study were in the middle age group of 40-49 years(41.6%). Out of 60 patients, 35 were males (58.4%) and 25 were females (41.6%). Patients withoutdoor activities had a higher prevalence of pterygium (78.4%). The incidence of pterygium wasmore in the right eye (60%) than left eye (40%). Of the 60 patients, Grade I, II and III pterygiumwas 20%, 56.7% and 23.3% in group A and 16.7%, 63.3% and 20% in group B respectively. Themean symptomatic score was statistically significantly higher for group A for each factor (P<0.05).In the 3rd month, the overall patient’s satisfaction score was significantly higher in group B(P<0.05). Conclusion: Both surgical techniques were equally effective in terms of visual acuity,astigmatism and recurrence. The patient’s satisfaction score was significantly higher in the rotationflap technique group.

scholarly journals Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Abdul Rafe ◽  
Saquib Naeem ◽  
Tariq Munawar
Keyword(s):  
Fibrin Glue ◽  
Sampling Technique ◽  
Autologous Serum ◽  
Bulbar Conjunctiva ◽  
Dry Eyes ◽  
Conjunctival Autograft ◽  
Quasi Experimental ◽  
Group A ◽  
Pterygium Excision ◽  
Group B

Purpose:  To compare the outcomes of conjunctival autograft fixation using autologous serum vs fibrin glue to cover the bare sclera in pterygium excision surgery. Study Design:  Quasi experimental study. Place and Duration of Study:  The study was conducted in Ophthalmology Department of CMH Kharian from April 2018 to November 2018. Material and Methods:  Forty patients with primary pterygium were selected by convenient sampling technique. Patients with recurrent Pterygia and moderate to severe dry eyes, keratitis or secondary to trauma were excluded. The patients were divided into two groups, group A treated with fibrin glue and group B treated with autologous serum technique. All patients underwent pterygium excision under topical anaesthesia. The conjunctival autograft was removed from superior temporal bulbar conjunctiva to cover the scleral bed produced by pterygium excision. Post operatively the patients were followed-up for three months to assess the fixation or otherwise. Data was noted and analysed by using SPSS version 23. Results:  The graft was taken-up nicely in most of the cases. The patients were followed up for three months after surgery. The frequency of graft lost in Group A and Group B was noted as n = 8 (40%) and n = 1 (5%), respectively (p = 0.008). The only other complication was recurrence of pterygium which was n = 5 (25%) and n = 3 (15%), in Group A and Group B, respectively (p = 0.429). No case of infection was noted. Conclusion:  Fixation of conjunctival autograft with autologous serum is a safe and effective method and potential alternative of fibrin glue technique.

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