scholarly journals Recurrence Rate of Primary Pterygium Following Excision with Mitomycin C versus Excision with Amniotic Membrane Transplant

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Jawad Humayun ◽  
Mubashir - Rehman ◽  
Mohammad Farhan ◽  
Muhammad Kashif Kamran ◽  
Shahid Abdur Rauf Khan

Purpose: To compare recurrence rate of primary pterygium following excision with mitomycin c verses excisionwith amniotic membrane transplant.Study Design: Quasi experimental study.Place and Duration of Study: Qazi Hussain Ahmad Medical Complex, Nowshera, from January 2019 to June2019.Material and Methods: One hundred and two patients presenting for the first time with pterygium were includedin the study and were divided into two groups. Patients having conjunctivitis, blephritis, keratitis or any otherocular inflammatory condition and patients having history of chemical burns and symblepharon were excludedfrom the study. Group A underwent surgical excision with 0.02% mitomycin–C application for 3 minutes andGroup B was surgically treated with application of amniotic membrane. Patients of both groups were followed upfor six months to detect recurrence of pterygium. Data was analyzed using SPSS version 20. Frequency andpercentages were calculated for categorical data like age, gender and recurrence rate. Recurrence rate wasstratified among age and sex to see the effect modifiers.Results: Mean age in both groups was 39.98 ± 9.11 years. In group A, 64.70% patients were males and in groupB, 62.74% patients were male. Recurrence of Pterygium was seen in 21.5% patients in group A and 7.84% ingroup B. The difference was statistically significant with a p value of 0.05.Conclusion: Recurrence rate of primary pterygium following excision with mitomycin C is higher than excisionwith amniotic membrane transplant

2021 ◽  
Vol 28 (04) ◽  
pp. 568-571
Author(s):  
Saira Bano ◽  
Sumaya Khan ◽  
Mahnoor Waqar ◽  
Moniba Iqbal ◽  
Hamza Waqar Bhatti ◽  
...  

Objective: To determine the difference in mean corneal curvatures before and after pterygium excision. Study Design: Quasi-experimental study. Setting: Department of Ophthalmology, Holy Family Hospital, Rawalpindi. Period: 1st January 2015 to 1st July 2015. Material & Methods: 68 patients aged between 18 to 65 years were included in the study. Patients with history of ocular trauma, ocular surgery, glaucoma, anti-glaucoma treatment, allergy to steroids, pseudo pterygium, recurrent pterygium and presence of corneal abnormalities such as, scarring that might affect the astigmatic value were excluded. All patients underwent comprehensive ophthalmic examination by slit lamp and best corrected visual acuity and keratometric values were noted. Pterygium excision was done by a single surgeon. BCVA and keratometric readings were taken again after 2 weeks of pterygium excision. Results: Mean age was 37.60 ± 11.11 years. Out of these 68 patients, 44 (64.71%) were male and 24 (35.29%) were females. Mean pre-operative corneal curvature was 2.99 ± 0.69D and post-operative corneal curvature was 1.70 ± 0.40D with P-value of <0.0001 which is statistically significant. Conclusion: This study concluded that pterygium excision brings significant change in corneal curvature in patients of pterygium induced astigmatism.


2021 ◽  
Vol 14 (1) ◽  
pp. 82-87
Author(s):  
Khalil M. Al-Salem ◽  
Ahmad T.S. Saif ◽  
Passant S. Saif

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.


2018 ◽  
Vol 21 (04) ◽  
pp. 704-716
Author(s):  
Aqdas Saqib ◽  
Saqib Ismail ◽  
Saadia Yasir

Objective: The objective of this study is to compare the effects of inhaledbeclomethasone with oral montelukast in long term management of moderate persistent asthmain children. Design: Quasi experimental study. Period: 6 months, from July 20,2007 to January20, 2008. Settings: Out patient paediatric department at Fauji Foundation hospital, Rawalpindi.Material and Methods: 8o children between 5-12yrs of age presenting with moderate persistentasthma, divided in two groups of 40 each. Group A treated with beclomethasone inhaler whileGroup B was started on oral montelukast. Drugs effect was recorded on a 2 wkly proforma for 8weeks. Results: There were 54(67.5%) male and 26(33%) female. Most common triggeringfactor seen in 54(67.5%) patients was recent history of respiratory tract infection, exposure tocarpet dust in 43(53.75%), cigarette smoke in 42(52.5%),recent psychological stress in 28(35%) ,pollen allergy in 26 (32.5%) , pets exposure in 8 (10%) and to mite was noticed in 5(6.25%)children. Marked improvement was observed in day time cough in group A with 10(25%) patientsbeing free of cough with inhaler, while 20(50%) showed mild intermittent symptoms. 1(2.5%)showed mild persistent symptoms. In Group B 3(7.5%) patients were symptom free,23(57.5%)with mild intermittent and 4(10%) with mild persistant symptoms while 6(15%)continued to have moderate persistent symptoms. P value was 0.01. Regarding day timebreathlessness, P value was significant of 0.258. Similarly marked improvement was observed innight symptoms of breathlessness, cough and sleeplessness in both groups. P value was lessthan 0.05 in majority of the variables showing statistically significant improvement with inhaledbeclomethasone than with oral montelukast. Conclusions: Inhaled beclom


Author(s):  
Prachi Shukla ◽  
Suman Bhartiya

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Waleed Alsarhani ◽  
Saeed Alshahrani ◽  
Mahmood Showail ◽  
Nawaf Alhabdan ◽  
Osama Alsumari ◽  
...  

Abstract Background This study described the clinical features of patients with pterygium and analyzed the recurrence rate of conjunctival autografting alone, conjunctival autografting combined with intraoperative mitomycin C, and amniotic membrane grafting. Methods A retrospective cohort study of primary pterygium was conducted between January 2017 and February 2020. Factors associated with pterygium severity and recurrence were analyzed by univariate analysis and logistic regression models. Results The study included 292 patients with an average age of 53.3 ± 14.1 years, while the number of operated cases was 94. Pterygia involving the cornea were observed in 55 % of the cases. The overall rate of recurrence for the three procedures was 17 %. The average time of recurrence was 14.2 ± 11.9 months, with 37 % of the recurrences occurring after the first year. The only factor associated with a significant risk of recurrence was dry eye disease in both univariate (p = 0.021) and multivariate analysis (p = 0.026). The recurrence rates following conjunctival autografting with and without mitomycin C were 15.6 and 15.8 %, respectively. The recurrence rate following the amniotic membrane graft was  twofold (OR= 2.02)  (27 %) that following the conjunctival autograft (15.8 %). Conclusions The only factor associated with the recurrence of pterygium was dry eye disease. More than one-third of recurrences developed after the first year, which stresses the importance of a long follow-up. The recurrence rate in our study following conjunctival graft was slightly higher compared to the literature mainly due to differences in study areas, populations, and follow-up periods.


2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash

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.


2017 ◽  
Vol Volume 11 ◽  
pp. 493-501 ◽  
Author(s):  
Alahmady Hamad Alsmman ◽  
Gamal Abd Ellateif Radwan ◽  
Mortada Ahmed Abozaid ◽  
Usama Ali Mohammed ◽  
Nesreen Gamal Eldein Abd Elhaliem

Author(s):  
Reema Bansal ◽  
R Sehgal

ABSTRACT Purpose To compare two techniques of human amniotic membrane transplantation (AMT) following pterygium excision: (1) end to end suturing of the amniotic membrane graft (AMG) with the conjunctiva versus (2) a new technique of purse-string suturing of the AMG and tucking of AMG under the free edge of conjunctiva. Materials and methods Pterygium surgery with human AMT was done in 42 eyes with primary pterygium. Twenty four eyes (group A) underwent end-to-end suturing of AMG with conjunctiva. Eighteen eyes (group B) underwent purse-string suturing of AMG with underlying sclera with free edge of AMG tucked under conjunctiva on three sides. The two groups were compared in terms of the outcome measures, i.e. complete epithelialization time of AMG and recurrence of pterygium within 1 year. Results The complete epithelialization of AMG occurred in 21 days (range 14 to 28 days) and 14 days (range 7 to 21 days) in groups A and B respectively. In group A, 7 eyes (29.17%) developed recurrence. In group B, 2 eyes (11.11%) developed recurrence. Conclusion Purse string suturing and tucking of AMG resulted in faster epithelization of AMG and lower recurrences in comparison with end to end suturing of AMG in the management of primary pterygium. How to cite this article Bansal R, Jain AK, Sehgal R. Amniotic Membrane Transplantation in the Treatment of Primary Pterygium: A Comparative Study of Two Techniques. J Postgrad Med Edu Res 2014;48(1):1-7.


2018 ◽  
Vol 10 (1) ◽  
pp. 071-077
Author(s):  
Husni Husni

The incidence of child development deviation in Indonesia reached 13% -18%.About 16% of children under five years got neurodevelopmental and brain disorders frommild to severe. This study aimed to determine the effect of brief training by using Pre-Screening Questionnaire Development (KPSP) to improve the knowledge and skills ofparents in detection of child development. This study was quasi experimental with preposttest only. The population in this study were the parents / guardians of children atkinder garten of Baitul Izzah and Al Hasanah Bengkulu City. Samples were parents whohave never participated in training and at least high school education. Number of samples56 (28 intervention and 28 control) taken with concecutive sampling techniques. Datacollection were using questionnaire for knowledge and checklist for skills. Statistical testindependent t-test at the α 5% (one tail). The results showed the average age was 33years, the average income was 2.3 million per month, more mothers working and havehigher education. There were the difference in knowledge after being given brief trainingof 27.5 (p value = 0.000) and the difference in ability between the intervention andcontrol groups (p value = 0.000). Effectiveness of brief training to increase the knowledgeof 35%. factor affecting the mother's knowledge was the age (p 0.001; OR: 2.12). Weconcluded that parents are expected to apply the child development detection according toability at home and it is needed training for other parents.


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