Abstract
Pterygium is a degenerative condition of subconjuctival tissue that undergoes elstotic degeneration and proliferates as vascular granulation tissue under the epithelium. This ultimately encroaches the cornea destroying its epithelium, superficial stroma and the Bowman’s membrane. It is occurs more commonly on the nasal side than the temporal side, but it can occur on both sides (double pterigium). Pathogenesis is mainly implicated to ultraviolet radiation exposure. It has highest prevalence and in the tropical areas near the equatorand to lesser abd milder degree in cooler climates. The increased levels of proangiogenic factors like basic fibroblast growth factor (BFGF), transforming growth factor Beta (TGF-b), vascular endothelial growth factor(VEGF) and platelet derived growth factor(PDGF) are responsible for formation and recurrence of Pterygium; however the most important of this growth factor is VEGF.To compare the efficacy of intraoperative subconjuctival injection of Triamcinolone and Bevacizumab with conjunctiva autograft alone in primary Pterygium surgery.Total 150 patients divided in three groups (50 patients of each group), underwent primary Pterygium surgery between MAY 2016 to APRIL 2017. In group A, Conjuctivialauto graft alone was done while in groups B & C, it was combined with Intraoperative Subconjuctival Injection of Triamcinolone (0.2mg/ml) and Bevacizumab, (2.5mg/0.1ml).Recurrence rate at 12 month was more in auto graft alone (group A) than in the auto graft in combination with Triamcinolone (group B) and Bevacizumab (group C) respectively.: Subconjuctival injection of Triamcinolone & Bevacizumab can be combined with Conjuctivialauto graft intraoperatively to prevent but Triamcinolone may prefer due to more cost effectiveness.
Highlights
Pterygium is a fibro vascular growth of bulbar conjunctiva, growing upon cornea on either side, usually from nasal part of the limbus within the palpebral aperture
In group A, Conjuctivialauto graft alone was done while in groups B & C, it was combined with Intraoperative Subconjuctival Injection of Triamcinolone 4 (0.2mg/ml) and Bevacizumab 5,6 (2.5mg/0.1ml)
Pterygium with grade T1 were seen in 17 patients, grade T2 were seen in 84 patients, grade T3 were seen in 39 patients
Summary
Pterygium is a fibro vascular growth of bulbar conjunctiva, growing upon cornea on either side, usually from nasal part of the limbus within the palpebral aperture. It is a common ocular surface disorder in hot tropical climate. Various method used to prevent the recurrence of pterygium are beta radiation mitomycine, thiotepa, 5 fluorouracil. These agents are tried intraoperatively in addition to surgical excision the recent trend is Conjuctivial autograph which shows less recurrence. Kumar / Indian Journal of Clinical and Experimental Ophthalmology 2020;6(1): angiogenesis the action of Triamcinolone is to suppress inflammation and, the role of Bevacizumabis is to suppress angiogenesis prevents the recurrence
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