Treatment Of Primary Pterygium Research Articles

Sub-conjunctival injection of 5 Fluorouracilversus Bevacizumab in Treatment of Primary Pterygium

Purpose: To compare effectiveness and safety of 5 Fluorouracil versus Bevacizumab as sole therapy in the treatment of primary pterygium. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Lahore, from January 2022 to January 2023. Methods: A total of 64 patients were included and divided into 2 groups of 32 patients each. Group A patients received monthlyinjection of 0.1ml, Fluorouracil(5FU) for 3 months while 3 injections of 0.1ml Bevacizumab were administered in group B. Primary outcome measure was effectiveness (defined as improvement in Pterygiumgrade), at 4 weeks following the administration of last injection. Patients were examined for pterygium grading as well as any side effects of injections on each follow up visit. Data analysis was done bySPSS, Version 23.0. Results: Mean age of patients in group A was of 33.53±11.3 yearsversus 30.97±12.6 years in group B with a range of 15–55 years. There were 45 (70.3%) males and 19 (29.7%) females. Improvement was seen in 21 patients (65.6%) in group A, as compared to only 2 (6.3%) in group B. There was a significant difference in pterygium improvement between the two groups (p<0.001). Conclusion: 5 Fluorouracil is more effective than Bevacizumab as sole therapy in treatment of primary pterygium but equally safe in terms of side effects.

Comparison of mini-simple limbal epithelial transplantation and conjunctival–limbal autograft for the treatment of primary pterygium: a randomised controlled trial

PurposeThe purpose of this double-masked, parallel randomised controlled trial was to compare the recurrence rate and other outcomes between conjunctival–limbal autograft (CLAu) and mini-simple limbal epithelial transplantation (mini-SLET) after excision...

Retracted: Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium.

[This retracts the article DOI: 10.1155/2022/5844973.].

Intralesional Injections of 5-Fluorouracil: innovative and effective treatment of Primary Pterygium

To determine the effectiveness of intralesional 5-Fluorouracil (5-FU) in symptomatic relief, astigmatism, and desire for surgery in patients with primary pterygium. The experimental study was carried out between January and March 2020 in the Ophthalmology Unit of the Hospital del Salvador, Chile. Fourteen eyes (14 patients) were selected on the surgical waiting list and exposed to fortnightly intralesional injections of 10 mg of 5-FU. An initial evaluation was performed with OSDI for symptomatic measurement, a photographic camera and slit lamp for clinical appearance, and an auto-refractometer for astigmatism, being re-evaluated 60 days later, adding the question of whether they maintained the desire to undergo surgery. The sample was divided into groups A and B depending on whether they received two or one dose of 5-FU, respectively. The average age of the participants was 56.8 ± 11.1 years. Group A presented an initial OSDI of 50 ± 23.8, which, after the intervention, decreased to 21 ± 13.5 (p < 0.001). Group B had an initial OSDI of 47 ± 17.3, decreasing to 22 ± 16.2 (p < 0.005)-statistically significant changes. The degree of astigmatism had no changes. Regarding the physical aspect, there was a reduction in the size of the lesion in 2 of the 14 patients, both in group A. Two patients decided not to undergo surgery after the intervention. The intralesional injection of 5-FU showed a significant improvement in symptomatic relief without associated complications, generating a therapeutic alternative in patients with primary pterygium without surgical indication.

Management of Primary Pterygium with Intralesional Bevacizumab (AVASTIN) Injection

Objective: To determine the management of primary Pterygium with intralesional Bevacizumab (AVASTIN) Injection.&#x0D; Study Design: Quasi-Experimental Study&#x0D; Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Oct 2019 to Mar 2020.&#x0D; Methodology: Sixty patients of Primary Pterygium with Grades 1, 2, and 3 were included. Pre-Intralesional injection evaluation includes the Ocular surface disease Index (OSDI), grading of Pterygium and ophthalmic examination, refraction,slit lamp bimicroscopy, fundoscopy, tonometry, and corneal topography. After four weeks of intralesional injection,reassessment was done. &#x0D; Results: A total of 60 participants with the mean age of the participants was 44.06±14.83 years were included in the study. In 26(43.3%) patients, grittiness, epiphora, redness, and photophobia were reported, and 16(26.6%) patients reported blurring of vision that improved in 100% of patients after intralesional injections. There was statistical significance (p-value ≤0.05) in means of K1, Sim K astigmatism, Surface asymmetry index, Surface Regularity Index, Grade of Pterygium, and Ocular surface disease index before and after the intralesional injection of Bevacizumab. However, no significant difference was recorded in Uncorrected Visual Acuity, Best Corrected Visual Acuity, and K2 parameters in pre and post-injection states (p-value ≥0.05).Only 7(11.6%) patients reported subconjunctival haemorrhage after the procedure.&#x0D; Conclusions: Treatment of Primary Pterygium with intralesional Bevacizumab injection successfully improves symptoms,Ocular Surface Disease Index, and reduces corneal astigmatism with minimum complications.

Cauterized conjunctival autograft with and without mitomycin C in primary pterygium surgery

Aim To compare between the outcomes of cauterized conjunctival autograft (CA) with and without mitomycin C (MMC) in primary pterygium surgery. Patients and methods This prospective interventional comparative study included 50 eyes in 50 patients with primary pterygium. Patients were randomly assigned into two equal groups: group 1 underwent pterygium excision with cauterized CA fixation, and group 2 underwent pterygium excision with cauterized CA fixation and intraoperative application of 0.02% MMC for 3 min. All patients underwent a preoperative, first day, first week, first month, third month, and sixth month postoperative ophthalmic examination. Any intraoperative or postoperative complications were recorded. Primary outcomes were reported as incidence of recurrence and any major (sight threatening) complications. Secondary outcomes were reported as any minor complications. Results A total of 50 patients (28 males and 22 females, with male to female ratio 1 : 1.3) were included in this study. Complications encountered in our study included recurrence of pterygium, which occurred in one (4%) eye in group 1 and 0 eyes in group 2. Two (8%) eyes in group 1 versus one (4%) eye in group 2 showed subconjunctival hemorrhage, one (4%) eye in group 2 showed focal scleral thinning, and one (4%) eye in group 2 showed a corneal epithelial defect. There was no statistically significant difference between the two groups regarding the incidence of any complication (P&gt;0.05). Conclusion Cauterized CA without MMC is a safe and effective procedure for the surgical treatment of primary pterygium. There was no added benefit to intraoperative MMC application.

Comparison of the effects of pterygium resection combined with dry or hydrated amniotic membrane transplantation in the treatment of primary pterygium

Comparison of the effects of pterygium resection combined with dry or hydrated amniotic membrane transplantation in the treatment of primary pterygium

Comparison of surgical techniques for recurrent pterygium

ObjectifSi l'autogreffe conjonctivale (AGC) et la greffe de membrane amniotique (GMA) s'accompagnant de mitomycine-C (MMC) représentent les traitements les plus efficaces du ptérygion primitif, on ne sait toujours pas quel est le meilleur traitement chirurgical du ptérygion récurrent. Nous avons donc entrepris d'examiner le taux de récurrence du ptérygion récidivant après son exérèse chirurgicale réalisée par ACG ou par GMA avec ou sans MMC. MéthodesNous avons réalisé un examen rétrospectif des dos..;’siers médicaux de patients adultes qui ont subi l'exérèse chirurgicale d'un ptérygion récurrent au Boston Medical Center entre janvier 1999 et juillet 2019. Le taux de récurrence postopératoire a été comparé entre 4 groupes de traitement chirurgical: AGC + MMC, AGC, GMA + MMC et GMA. Ont également été enregistrées les complications peropératoires et postopératoires. RésultatsAinsi, 41 yeux de 38 patients ayant subi l'exérèse chirurgicale d'un ptérygion récurrent répondaient à nos critères. Le taux de récurrence postopératoire observé se chiffrait à 0 % (0 œil sur 8) dans le groupe AGC + MMC, à 17,7 % (3 yeux sur 17) dans le groupe AGC, à 45,5 % (5 yeux sur 11) dans le groupe GMA + MMC et à 80,0 % (4 yeux sur 5) dans le groupe GMA. Le taux de récurrence postopératoire était significativement moindre dans le groupe AGC, comparativement au groupe GMA, tant avec (p = 0,045) que sans (p = 0,021) administration adjuvante de MMC. On ne note aucune différence statistiquement significative quant au taux de nouvelle récurrence avec ou sans MMC dans les groupes AGC (p = 0,52) ou GMA (p = 0,31). Il s'est produit 1 cas de complication possible de l'administration de MMC qui aurait entraîné la dissolution complète de la membrane amniotique. ConclusionsLes résultats de notre étude portent à croire que l'AGC se traduit par un taux moindre de nouvelle récurrence que la GMA dans le traitement chirurgical du ptérygion récurrent. L'administration peropératoire de MMC pourrait diminuer le taux de récurrence, mais la diminution n'est pas significative sur le plan statistique, sans compter que la MMC peut entraîner des complications.

Efficacy and Safety of Amniotic Membrane Transplantation Combined with Closure of Tenon Capsule and Bulbar Conjunctival Space in the Treatment of Primary Pterygium.

Objective The aim of the study is to evaluate the safety and effectiveness of amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space. Methods This study retrospectively included 100 patients with primary pterygium who received closed bulbar conjunctiva and tenon capsule space combined with amniotic membrane transplantation in our hospital from January 2020 to June 2021 as the experimental group and 100 patients with routine treatment in the same period as the control group. The postoperative efficacy evaluation and postoperative complications of the two groups were compared, so as to comprehensively evaluate the safety and effectiveness of this method. Results The results showed that the postoperative complications of the two groups were significantly improved by Fisher's exact test (χ2 = 14.510, P = 0.006 < 0.05). The comparison results showed that the treatment group showed significant advantages in six indexes compared with the observation group and the difference between the two groups was statistically significant (P < 0.05) of in the NRS score, Prabhasawat score, inspection of the ocular surface comprehensive analyzer, corneal fluorescein staining, conjunctival fluorescein staining in the operation area, breakup time of tear film examination of the two groups at 3, 7 and 14 days, and 1, 6 and 12 months after the operation. Conclusions Amniotic membrane transplantation combined with the closure of the tenon capsule and bulbar conjunctival space is safer than conventional surgery in the treatment of primary pterygium. It has a shorter recovery time, higher safety, and a positive curative effect. It can be considered to popularize this operation in clinic.

Evaluation of outcome of primary pterygium excision combined with different techniques

To compare different techniques combined with excision in treatment of primary pterygium: Amniotic membrane transplant [AMG], Limbal-conjunctival autograft [CLAG], and mitomycin c with limbal-conjunctival autograft.[MMC+CLAG]: A prospective comparative study was performed in tertiary hospital on 105 patients satisfying the inclusion and exclusion criteria. Combined with excision, 35 eyes each were treated with AMG transplantation [Group 1] and CLAG [Group 2] for closure of defect. In 35 eyes low-dose mitomycin -C [0.02%] was applied on bare sclera for 1 minute and a CLAG was applied thereafter [Group 3]. Patients were followed up for 9 months.Study was conducted from June 2018 to April 2020 on patients of age 26 to 72 years with mean age of 46.3 ± 10 years with 42[40%] male and 63[60%] female. A statistically significant change [ paired t test, p&amp;#60;0.001] was noted in K-horizontal value pre- and post- pterygium surgery. Change in K-vertical pre- and post- surgery was not statistically significant [paired t test, p&amp;#60;0.58]. Pterygium recurred in 3 patients [8.6%] in group 1, 1 patient [2.9%] each in group 2 and 3. Other postoperative complications include graft displacement [5.7%], graft oedema [6.7%] and congestion [9.5%]. A minor case of scleral melting was noted in one patient [2.9%] in group 3. Pterygium excision followed by CLAG and MMC+CLAG are an effective way of reducing recurrence. However close monitoring is required for use of adjuvant MMC.AMG can be reserved in patients with bilateral pterygium, severe limbal stem cell loss and in need of glaucoma surgery.

Green Tea Catechins Attenuate Human Primary Pterygium Cell Survival and Migration Via Modulation of ERK p42/p44 and p38 Pathways.

Pterygium belongs to an ocular surface disease with triangular-shaped hyperplastic growth, characterized by conjunctivalization, inflammation, and connective tissue remodeling. We previously demonstrated neoplastic-like properties of pterygium cells. Green tea catechin, (-)-epigallocatechin gallate (EGCG), has been shown to possess antitumorigenic properties; herein, we aimed to determine the effects of green tea catechins on human primary pterygium cell survival and migration and compared to that on patients' conjunctival cells. Both human primary pterygium and conjunctival cells expressed EGCG receptor, the 67 kDa laminin receptor. Seven-day treatment of green tea extract (Theaphenon E; 16.25 μg/mL) and EGCG (25 μM) attenuated pterygium cell proliferation by 16.78% (p < 0.001) and 24.09% (p < 0.001) respectively, without significantly influencing conjunctival cells. Moreover, green tea extract (16.25 μg/mL) and EGCG (25 μM) treatments also hindered pterygium cell migration by 35.22% (p < 0.001) and 25.20% (p = 0.019), respectively, but not conjunctival cells. Yet, green tea extract and EGCG treatments did not significantly induce pterygium cell apoptosis. Furthermore, green tea extract and EGCG treatments significantly increased the phosphorylation of p38 protein but reduced the phosphorylation of p42/p44 protein in pterygium cells. In summary, this study revealed that green tea extract and EGCG attenuated human primary pterygium cell survival and migration in vitro without damaging conjunctival cells, suggesting a novel potential therapeutic approach for primary pterygium treatment.

COMPARISON OF RECURRENCE INCIDENCE AFTER PTERYGIUM EXCISION BY USING PEROPRATIVE SUBCONJUNCTIVAL BEVACIZUMAB INJECTION VERSUS CONJUNCTIVAL AUTO GRAFT

Background: A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. The tissue is fibrovascular and can occur over the nasal or temporal cornea. It can be a bilateral process and asymmetric with one eye affected by a larger pterygium than the other. Objectives: To compare between Subconjunctival injection of bevacizumab (Avastin) and conjunctival autograft in the treatment of primary pterygium. Patients and Methods: This study was performed on 40eyes of 40 patients with primary pterygia of variable durations. The eyes were randomly classified into two equal groups: group A patients to be treated by Subconjunctival Bevacizumab (avastin) 0.2 ml (5 mg) for Primary Pterygium Excision, group B patients treated by conjunctival auto graft. Best corrected visual acuity, occurrence of recurrence, IOP and postoperative complications were compared. Patients were evaluated preoperatively then 1 day, 1 week, 1 month, 3 months after surgery. Eye photography was done before surgery and during the follow up period. This study was conducted at Department of Ophthalmology Al-Azhar University Hospital and Kobry El Kobba Military Hospital, from August 2018 to July 2020. Results: When the two groups were compared together, we found no statistically significant differences among them in multiple compared items, but the recurrence rate in group A (bevacizumab group) occurred in (10%), while in group B conjunctival auto graft no recurrence occurred and this was statistically insignificant difference among the 2 groups. There were no statistically significant differences regarding improvement in visual acuity, intraocular pressure change and postoperative complications among the two groups. Conclusion: A single preoperative subconjunctival injection of bevacizumab had decreased the recurrence rate befor primary pterygium excision, but did not give a more desirable recurrence rate. On the other hand conjunctival autograft was more effective than bevacizumab in reducing the recurrence rate of primary pterygium after surgical excision.

Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study

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.

RECURRENCE RATE AFTER CONJUNCTIVAL AUTOGRAFT VESUS INTRAOPERATIVE MITOMYCIN C FOR TREATMENT OF PRIMARY PTERYGIUM

ABSTRACT Background: pterygium is a common disease that affect many people in the world especially in the tropics and in an equatorial zone between 30° north and south latitudes. Egypt is one of the highly affected contraries. The most important problem in treatment of pterygium is high recurrence rate. Aim: to compare conjunctival autograft and intraoperative mitomycin C to determine the best technique that can reduce the recurrence rate. Methodology: this prospective interventional study comprised 40 eyes of 40 patients with primary pterygium included from the outpatient clinics of the ophthalmology departments at Al-Zahraa University Hospital and The Italian Military Hospital over a period of 15 months (from March 2019 to May 2020). They were randomized into two groups according to the adjuvant used: (1) intraoperative 0.02% MMC for 3 minutes or (2) conjunctival autografting technique. Patients were followed for recurrence and complications for a period of 6 months. Results: 40 eyes of 40 patients their age ranged from 21 and 65 years in group (1) and between 27 and 60 years in group (2) with a male predominance of 30 cases (75%). There were 2 recurrences (10%) in MMC group and 1 recurrence (5%) in conjunctival autograft group. There was no statistically significant difference in the recurrence rate between the two groups. There were 2 cases of granuloma one case in each group and one case of partial graft dehiscence in group 2. Conclusion: Both conjunctival autograft and intraoperative mitomycin C techniques are effective treatment modalities for treatment of primary pterygium and for reduction of recurrence rate. There is no significant difference between both techniques as regards the recurrence rate.

Pterygium excision with modified bare sclera technique combined with mitomycin C.

Numerous surgical methods, with varying rates of recurrence, have been applied for the treatment of pterygium. Adjuvant mitomycin C (MMC) application has shown promising results in the prevention of recurrence. Here we propose and describe modified bare sclera technique combined with the intraoperative application of MMC for pterygium excision. Retrospective study. Primary pterygium patients who underwent pterygium excision via the bare sclera combined with 0.04% MMC technique from January 2014 to December 2016 were reviewed. In all patients, the subconjunctival pterygium strand was exposed and then sufficiently excised in combination with the safe use of MMC; i.e., the prevention of MMC dilution and diffusion to surrounding tissue. Surgical complications, recurrence rates, and recurrence onset were recorded. This study involved 32 primary pterygium eyes (grade T1 = 22 eyes; 68.7%). The mean postoperative follow-up period was 26.4 ± 14.5months (range: 12-60months). MMC was applied for 1-3min. The mean complete epithelialization was 12.6 ± 7.6days and no surgical complications were observed. In 1 patient with double-head primary pterygium, recurrence occurred at 15-months postoperative. The modified bare sclera technique combined with MMC application was found to be safe, effective, and presents good cosmetic appearance for the treatment of primary pterygium when safety points are strictly applied.

Preliminary observation on the treatment of primary pterygium with modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon eye drops

Objective: To observe the clinical effect of modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon (IFN) alpha-2b eye drops in the treatment of primary pterygium. Methods: This was a prospective case-control study. Patients with primary pterygium were treated from June 1, 2018 to December 31, 2018 in the Department of Ophthalmology, Beijing Tongren Hospital, and they were divided into two groups (the experimental group and the control group) by the method of randomized block design. Patients in the experimental group received modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops, while patients in the control group received pterygium resection combined with conjunctival autograft transplantation. The pterygium type and size were observed before operation, while visual acuity, intraocular pressure and anterior segment details were recorded either. The follow-up was done at 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months after operation. The visual acuity, corneal epithelial defect, and pterygium recurrence were observed. All data in this manuscript are enumeration data, the expected frequency of pterygium type distribution in the two groups was more than 5, and the chi square test was used, fisher's exact test was used to compare the other data between the two groups. Results: Seventy patients (77 eyes) with pterygium were in this study, including 30 males and 40 females, aged from 50-70 years old. There were 35 cases (38 eyes) in the experimental group and 35 cases (39 eyes) in the control group. 12 months after operation there were 54 cases (60 eyes) including 28 cases (30 eyes) in the experimental group and 26 cases (30 eyes) in the control group with complete data. The corneal epithelium defects of 1 eye in each group was repaired within 7-14 days after operation, and the rest eyes were completely repaired within 7 days after operation. There was no significant difference in the distribution of corneal epithelial healing between the two groups (P= 1.00). There was no significant difference between the two groups in the number of eyes distribute with decreased visual acuity (2 eyes in each group), stable visual acuity (15 eyes in the experimental group and 23 eyes in the control group), and improved visual acuity (13 eyes in the experimental group and 5 eyes in the control group) (P=0.053). There was no recurrence in the two groups at 12 months after surgery, and there was no significant difference between the two groups in the number of patients with conjunctival hyperplasia of grades 1, 2 and 3 (P=0.405). Conclusions: Modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops got low recurrence rate for primary pterygium and less damage to the healthy conjunctival tissue. This combined treatment strategy provides a new choice for the treatment of pterygium. (Chin J Ophthalmol, 2020, 56: 768-773).

Comparison between limbal stem cell versus dry amniotic membrane transplantation in treatment of primary pterygium

Abstract Background Pterygium is a degenerative disorder of the conjunctiva which leads to encroachment of bulbar conjunctiva onto the cornea. This invasion causes irritation of ocular surface, irregular astigmatism and loss of visual acuity.surgical treatment of pterygium is directrd towards excision, prevention of recurrence and restoration of ocular surface integrity. A myriad of techniques have been described for achieving these goals. Tha main complication of these procedures is the recurrence rate, which has been estimated as high as 30%_70%. Purpose to compare the efficiency of limbal stem cell transplantation versus dry amniotic membrane transplantation in treatment of pterygium. Patients and Methods The study carried out at ophthalmology department, Ain shams university and included 20 eyes which were classified into two groups; first group included 10 eyes of patients underwent pterygium excision with amniotic membrane transplantation. Second group included 10 eyes of patients underwent pterygium excision with limbal stem cell transplantation. Results the mean follow up duration was 1-3 months in both groups. On comparing recurrence rate between the studied groups which occurred only in the first group in two eyes 20%, there is no statistically significant difference found between the studied groups as regard recurrence. But it was statistically significant better with limbal conjunctival autografting. Graft rejection was not detected in the two groups during follow up period. There was no statistically significant difference found between the studied groups as regard clinical stability and graft rejection. Conclusion Limbal stem cell transplantation proved to be better than amniotic membrane transplantation in treatment of pterygium. As it is more effective in prevention of pterygium reccurence as well as it is of lower cost and better availability than amniotic membrane.

Practice Patterns in the Management of Primary Pterygium: A Survey Study.

To characterize cornea specialists' current practice preferences in the management of primary pterygium. A 25-item survey regarding indications for surgery, surgical technique, use of adjuvant therapy, type and duration of postoperative therapy, and treatment of early recurrences was designed and sent to members of the Cornea Society through the kera-net listserv. In total, 199 cornea specialists completed the questionnaire. More than 90% considered that surgery should be performed when there is proximity of the pterygium to the visual axis, pain or redness, eye movement restriction, or induction of astigmatism. Cosmesis was considered as an indication by 41.7% of the participants. The most frequent technique for pterygium excision was complete resection including the base and a moderate quantity of Tenon capsule followed by autologous conjunctival or limbal-conjunctival graft. The preferred graft fixation method in this survey was fibrin glue (61.2%). Most respondents reported a recurrence rate of less than 5% and no use of adjuvant agents to prevent recurrence. When early recurrence did occur, the preferred agents were corticosteroids. This study reflects the preferences of cornea experts regarding primary pterygium treatment and may serve as a guide for the management of this pathology.

A Comparison Between Bevacizumab and Mitomycin C in Treatment of Primary Pterygium

Background: A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. The tissue is fibrovascular and can occur over the nasal or temporal cornea. It can be a bilateral process and asymmetric with one eye affected by a larger pterygium than the other. Objective: To compare between the effects of intraoperative subconjunctival injection of Bevacizumab (Avastin) and intraoperative topical Mitomycin C on the outcome of primary pterygium surgery as regard efficacy and complications. Methods: Prospective, randomized, comparative clinical study was done on twenty eyes of twenty patients complaining of primary pterygium of variable duration that were surgically treated by simple excision. In addition to surgical excision, postoperative subconjunctival injection of bevacizumab was done for 10 eyes (group A), and postoperative application of mitomycin C (MMC) was done for 10 eyes (group B). The postoperative outcome was followed clinically for a minimum of 6 months and the main outcome criteria were recurrence rate and postoperative complications. Results: A significant high recurrence rate was found in bevacizumab group (60%) in comparison to MMC group (10%). In group A subconjunctival hemorrhage was detected in 2 cases while no complications were detected in group B. Conclusion: A single intraoperative subconjunctival injection of bevacizumab had decreased the recurrence rate after primary pterygium excision which seems to be marginally superior to bare sclera excision alone, but does not give a more desirable recurrence rate with insignificant complications as subconjunctival hemorrhage which resolved within 2 weeks.

A Comparison Between Bevacizumab and Mitomycin C in Treatment of Primary Pterygium

Background: A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. The tissue is fibrovascular and can occur over the nasal or temporal cornea. It can be a bilateral process and asymmetric with one eye affected by a larger pterygium than the other. Objective: To compare between the effects of intraoperative subconjunctival injection of Bevacizumab (Avastin) and intraoperative topical Mitomycin C on the outcome of primary pterygium surgery as regard efficacy and complications. Methods: Prospective, randomized, comparative clinical study was done on twenty eyes of twenty patients complaining of primary pterygium of variable duration that were surgically treated by simple excision. In addition to surgical excision, postoperative subconjunctival injection of bevacizumab was done for 10 eyes (group A), and postoperative application of mitomycin C (MMC) was done for 10 eyes (group B). The postoperative outcome was followed clinically for a minimum of 6 months and the main outcome criteria were recurrence rate and postoperative complications. Results: A significant high recurrence rate was found in bevacizumab group (60%) in comparison to MMC group (10%). In group A subconjunctival hemorrhage was detected in 2 cases while no complications were detected in group B. Conclusion: A single intraoperative subconjunctival injection of bevacizumab had decreased the recurrence rate after primary pterygium excision which seems to be marginally superior to bare sclera excision alone, but does not give a more desirable recurrence rate with insignificant complications as subconjunctival hemorrhage which resolved within 2 weeks.