Новый подход к хирургическому лечению первичного прогрессирующего птеригиума

Abstract

Purpose. To evaluate effectiveness of new method of barrier amnioplasty in surgical treatment of primary progressive pterygium. Material and methods. The study included 64 patients (64 eyes) with primary progressive pterygium. All patients were divided into two groups depending on method of barrier amnioplasty. The main group consisted of 32 people (32 eyes) who underwent barrier amnioplasty in the area of initial growth of pterygium. The control group consisted of 32 patients (32 eyes) who underwent barrier amnioplasty in the limbus area. The main criterions for clinical efficacy of surgical treatment of pterygium was dynamics of the wound process, the Ocular Surface Disease Index (OSDI) and the osmolarity of the tear fluid in the compared groups. Also, after 1 year, the frequency of pterygium recurrence was assessed. In addition to standard ophthalmological examinations, special methods were used in the work: determination of the osmolarity of the tear fluid, pH of tears, cytological assessment of the wound process, and also assessed the OSDI. Results. The results of pH-metric, osmometric, cytological studies have provided evidence of the ability of the anatomical and topographic approach described by us to positively influence the course of inflammatory and reparative processes in the operation area, preventing the development of recurrent pterygium and cicatricial deformities. Conclusion. A new effective method of surgical treatment of primary progressive pterygium, including moving the area of the barrier amnioplasty from the limbus area to the area of initial growth of blood vessels of pterygium - the area of the lunate fold, has been developed and introduced into clinical practice. Key words: pterygium, inflammatory and reparative processes, recurrence.