Abstract
Purpose To evaluate the association between pinguecula excision and subsequent improvement in dry eye syndrome. Methods We included 30 consecutive patients with primary nasal pinguecula and dry eye symptoms undergoing ocular surgery for the first time. Criteria for pinguecula excision surgery were nasal location, yellowish color, and protrusion of conjunctiva at least 2 times thicker than adjacent normal conjunctiva as measured by anterior segment optical coherence tomography. Our primary outcomes were 3-month postoperative changes in tear film breakup time (TBUT), Schirmer test, and a dry eye symptom score. Results 30 eyes from 30 different patients (12 men and 18 women) underwent pinguecula excision and conjunctival autografting using fibrin glue. The mean age was 42.5 ± 8.35 (range 28–63) years. The preoperative protrusion ratio of pinguecula was 2.33 ± 0.28 (range 2.00–2.90). Mean preoperative TBUT, Schirmer test, and dry eye symptom scores were 5.10 ± 1.27 seconds, 6.07 ± 2.27 mm, and 2.80 ± 0.76 points. Mean postoperative 3-month TBUT, Schirmer test, and dry eye symptom scores were 7.80 ± 1.13 seconds, 7.27 ± 2.02 mm, and 0.30 ± 0.47 points, respectively. The median pre- and postoperative changes were found to be statistically significant by Wilcoxon signed-rank tests for TBUT, Schirmer test score, and dry eye symptom score. Conclusion Surgical excision of pinguecula and conjunctival autograft using fibrin glue is an effective and safe method to improve symptoms of dry eye syndrome.
Highlights
A pinguecula is a round, yellowish, elevated fleshy tissue on the bulbar conjunctiva
After pinguecula excision with conjunctival autograft, it showed vascular shrinkage and flattening of the conjunctival surface (Figure 2). ere was no case of recurrence during the follow-up periods
We found that all included measures of dry eye syndrome (TBUT, Schirmer test, and dry eye symptom score) improved after surgery. is improvement was statistically and clinically significant. ere was objective 3-month improvement postoperatively in average tear film breakup time (TBUT) and Schirmer test scores of 2.7 sec and 1.2 mm, respectively, and subjective improvement from symptoms on average being continuous and impacting quality of life to at worst being occasional and not bothersome
Summary
Received 23 December 2018; Revised 15 April 2019; Accepted 23 April 2019; Published 9 June 2019. We included 30 consecutive patients with primary nasal pinguecula and dry eye symptoms undergoing ocular surgery for the first time. Our primary outcomes were 3-month postoperative changes in tear film breakup time (TBUT), Schirmer test, and a dry eye symptom score. 30 eyes from 30 different patients (12 men and 18 women) underwent pinguecula excision and conjunctival autografting using fibrin glue. Mean preoperative TBUT, Schirmer test, and dry eye symptom scores were 5.10 ± 1.27 seconds, 6.07 ± 2.27 mm, and 2.80 ± 0.76 points. Mean postoperative 3-month TBUT, Schirmer test, and dry eye symptom scores were 7.80 ± 1.13 seconds, 7.27 ± 2.02 mm, and 0.30 ± 0.47 points, respectively. Surgical excision of pinguecula and conjunctival autograft using fibrin glue is an effective and safe method to improve symptoms of dry eye syndrome
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