Underwent Pterygium Excision Research Articles

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.

The Effect of Pterygium Surgery on Corneal Topography

Abstract Objective To evaluate the effect of pterygium surgery on corneal topography by comparing wave front analysis before and one month after the surgical treatment. Methodology Fifty eyes of forty-one patients were included in this study. Twenty five male and sixteen female patients seeking pterygium surgery were recruited from the Ophthalmology Department Outpatient Clinic in Sohag Teaching Hospital during the period from July 2017 to May 2018. All eyes underwent pterygium excision with conjunctival autograft. Results In this study we found a highly statistically significant improvement in the mean uncorrected visual acuity from 0.44±0.21SD preoperatively to 0.62±0.18SD postoperatively (p < 0.001) and a highly statistically significant difference in the mean logMAR visual acuity as it was decreased from 0.43±0.28 SD preoperatively to 0.34±0.23 SD postoperatively (p < 0.001). Also, there was a highly statistically significant improvement in mean of manifest refractive astigmatism from -4.08±3.28 SD preoperatively to -1.46±1.40 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean cycloplegic astigmatism from -4.00±3.01 SD preoperatively to -1.39±1.33 SD postoperatively (p < 0.001) and also there was a highly statistically significant improvement in the mean topographic astigmatism from -5.17±4.08 SD preoperatively to -2.20±2.31 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean of ISV (Index of Surface Variance) from 76.22±36.86 SD preoperatively to 33.56±15.02 SD post operatively (p < 0.001) and also there was a highly statistically significant improvement in the mean IHD (Index of Height Decentration) from 0.042±0.027SD pre-operatively to 0.023±0.036 SD post operatively. Conclusion There was a highly statistically significant difference in the mean logMAR visual acuity and a highly statistically significant improvement in the mean uncorrected visual acuity. A highly statistically significant improvement in both refractive and topographic astigmatism after one month of the surgery was noted also. Here were also a highly statistically significant improvement in ISV and IHD that indicate improvement after pterygium removal. Recommendations Patient with pterygium that inducing astigmatism will benefit from surgical removal of the pterygium.

Fibrin Glue Versus Autologous Serum for Conjunctival Autograft Fixation in Pterygium Surgery

Purpose: To compare the outcomes of conjunctival autograft fixation using autologous serum vs fibrin glue to cover the bare sclera in pterygium excision surgery.
 Study Design: Quasi experimental study.
 Place and Duration of Study: The study was conducted in Ophthalmology Department of CMH Kharian from April 2018 to November 2018.
 Material and Methods: Forty patients with primary pterygium were selected by convenient sampling technique. Patients with recurrent Pterygia and moderate to severe dry eyes, keratitis or secondary to trauma were excluded. The patients were divided into two groups, group A treated with fibrin glue and group B treated with autologous serum technique. All patients underwent pterygium excision under topical anaesthesia. The conjunctival autograft was removed from superior temporal bulbar conjunctiva to cover the scleral bed produced by pterygium excision. Post operatively the patients were followed-up for three months to assess the fixation or otherwise. Data was noted and analysed by using SPSS version 23.
 Results: The graft was taken-up nicely in most of the cases. The patients were followed up for three months after surgery. The frequency of graft lost in Group A and Group B was noted as n = 8 (40%) and n = 1 (5%), respectively (p = 0.008). The only other complication was recurrence of pterygium which was n = 5 (25%) and n = 3 (15%), in Group A and Group B, respectively (p = 0.429). No case of infection was noted.
 Conclusion: Fixation of conjunctival autograft with autologous serum is a safe and effective method and potential alternative of fibrin glue technique.

Comparison of inferior conjunctival autografting and conjunctival tissue grafting from pterygium itself in the cases of filtering blebs and glaucoma suspects-A retrospective analysis.

Purpose:This study aims at comparing the effectiveness of inferior conjunctival autografting (CAG) and conjunctival tissue grafting from pterygium itself (CTG) in the cases of filtering blebs/glaucoma suspects.Methods:One hundered and five eyes of 97 patients who underwent pterygium excision with conjunctival autografting (CAG) in the period from 2010 to 2016 were included. Fifty one eyes had filtering blebs and 54 were glaucoma suspects. Fifty two eyes of 49 patients (Group 1) had undergone pterygium excision with inferior conjunctival autograft (CAG) and 53 eyes of 48 patients (Group 2) had undergone pterygium excision with conjunctival tissue graft (CTG) from the pterygium itself. The minimum follow up period was 6 months.Results:Both groups had 2 eyes with recurrence, which was not statistically significant. Among other complications, graft retraction was seen with a higher incidence in Group 2, which was statistically significant.Conclusion:In situations where sparing of the superior conjunctiva is mandatory, both the techniques of inferior conjunctival autografting and conjunctival tissue graft from the pterygium itself are excellent alternate options with comparable outcomes and no additional risk of significant complications.

Recurrence of Pterygium after Pterygium Excision with Stem Cell Graft and Amniotic Membrane Graft: A Comparison.

Study objectiveThe objective of this study was to compare pterygium excision with amniotic membrane graft and that with stem cell graft in terms of pterygium recurrence, using a quasi-experimental study design. This study was conducted at the department of ophthalmology at Nishtar Hospital, Multan, Pakistan from January to September 2019.Methodology and resultsA total of 214 patients who presented to the outpatient section at the department of ophthalmology were included in this study. A lottery method was used to divide the patients into two equal groups: A and B. Patients in group A underwent pterygium excision with amniotic membrane graft, and patients in group B underwent pterygium excision with stem cell grafts. Follow-ups were planned for the third day, the second week, the first month, the third month, and the sixth month postoperatively. Frequency and percentage were calculated for qualitative variables and for quantitative data. Mean and standard deviation were calculated, and a p-value of <0.05 was considered significant. Postoperative complications (i.e., graft edema, hemorrhage, and recurrence) in group A were observed as n = 0 (0%), n = 11 (10.3%), and n = 15 (14%), respectively. Postoperative complications (i.e., graft edema, hemorrhage, and recurrence) in group B were observed as 15%, 3.7%, and 12.1%, respectively. Statistically, the difference for graft edema was significant (p = 0.000).ConclusionStem cell grafting after pterygium excision was not associated with any major complications postoperatively. Stem cell grafting is better in terms of cosmetic appearance and has less recurrence rate as compared to amniotic membrane transplantation.

Antiangiogenic therapy in the surgical treatment of pterygium

To evaluate the effectiveness and safety of adjuvant anti-VEGF therapy in the surgical treatment of pterygium, and to determine the indications for its use. The study included 67 patients (69 eyes) with grade II-IV pterygium. Patients age was 58.8±12.6 years on average. Best corrected visual acuity (BCVA) varied between 0.01 and 1.0 (0.77±0.24). The patients were divided into 3 groups. The first group included 19 patients (19 eyes) with grade II-III pterygium who underwent «bare sclera» surgery and used aflibercept as adjuvant therapy. The second group included 21 patients (21 eyes) with grade II-IV pterygium who underwent auto conjunctival grafting surgery with no adjuvant therapy. The third group included 27 patients (29 eyes) with grade II-IV pterygium who had it removed in combination with single-time peripheral lamellar keratoplasty (PLK) and underwent adjuvant aflibercept therapy. Among patients who underwent pterygium excision with adjuvant antiangiogenic therapy there were 5 cases (26%) of relapse during the observation period (23.38±8.96 months), among patients after pterygium excision with auto conjunctival plastic surgery - also 5 cases (24%) of relapse, and among patients who underwent LKP combined with anti-VEGF therapy there was only 1 case (3%) of relapse. Astigmatism has decreased by 0.24±0.5 (p=0.052) in the first group, by 1.21±1.0 (p<0.05) in the second group, and by 1.64±1.54 (p<0.05) in the third group compared with pre-surgical values, thus increasing average BCVA in all 3 patient groups by 0.1±0.13, 0.07±0.11 and 0.15±0.15, respectively. The use of anti-VEGF agents as adjuvant therapy in the surgical treatment of pterygium is a safe method of reducing postoperative inflammation, fibrovascular proliferation and, subsequently, the amount of relapses.

Effects of excimer laser phototherapeutic keratectomy in limbal-conjunctival autograft transplantation for recurrent pterygium: a retrospective case control study

BackgroundRepeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent pterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in limbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium.MethodsRetrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without (control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and postoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were collected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were performed to monitor the cornea epithelium healing and cellular recovery process respectively.ResultsA total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK. The mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and 13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: − 0.88, 2.81), SAI decreased 0.53 (range: − 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding values were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group, respectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both groups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: − 0.12, 0.50) in the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and better cellular recovery.ConclusionsFor recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved corneal surface and vision outcomes.

Profile of Patients Undergoing Pterygium Excision with Suture Free Glue Free Conjunctival Autograft in a Hilly North Indian District

Profile of Patients Undergoing Pterygium Excision with Suture Free Glue Free Conjunctival Autograft in a Hilly North Indian District

Changes in Astigmatism Before and After Pterygium Surgery

Introduction: Pterygium is a degenerative condition of the subconjuctival tissue, which proliferates as vascularised granulation tissue to invade the cornea resulting in destruction of the superficial layer of the corneal stroma and bowman's membrane. This change in cornea leads to corneal opacity, visual impairment and significant induced astigmatism. The ensuing pathologic changes consist of elastoid degeneration of collagen and the appearance of subepithelial fibrovascular tissue&#x0D; Objective: To measure the change in corneal astigmatism after pterygium surgery and the relationship of astigmatism with respect to size of pterygium.&#x0D; Methodology: Hospital based prospective, non-randomized study, comprising 61 eyes of 56 patients who underwent pterygium excision and autologus conjuctival graft during the period October 2009 to September 2010. A total of 56 participants were enrolled and followed upto 3 months after surgery. Corneal topography was used to measure corneal astigmatism before and after pterygium surgery.&#x0D; Results: The mean age of patient was 46.11 years, standard deviation was 18.86 Male: female ratio: 0.8:1 Preexisting induced astigmatism among study group patients was 2.6D and mean astigmatism after pterygium surgery was 0.8D. This finding was found to be statistically significant(P value &lt;0.001). Over all change in mean astigmatism was 1D in our study. In grade I Mean astigmatism before surgery was 0.96D and Mean astigmatism after surgery was 0.46D, Changes in mean astigmatism after surgery was 0.50D. In grade II Mean astigmatism before surgery was 1.99D and Mean astigmatism after surgery was 0.54D, Changes in mean astigmatism after surgery was 1.45D. In grade III Mean astigmatism before surgery was 10.71D and Mean astigmatism after surgery was 3.10D, Changes in mean astigmatism after surgery was 7.61D. The change in mean astigmatism is greatest in patients with grade III pterygium.&#x0D; Conclusion: After pterygium surgery astigmatism significantly reduces and astigmatism increases with the grade of pterygium.

Optical Coherence Tomography Angiography for Evaluation of Reperfusion After Pterygium Surgery

To describe the use of optical coherence tomography angiography (OCTA) to quantitatively monitor the conjunctival graft revascularization after pterygium excision and conjunctival autograft (CAG) transplantation. Prospective, interventional case series. Ten patients undergoing pterygium excision and femtosecond laser-assisted CAG transplantation were included. OCTA was performed at 1week, 1 and 3months postoperatively at the CAG transplantation site and harvested area. The vessel density at three different depths: conjunctival epithelium or CAG epithelium, conjunctival stroma or CAG stroma, and episclera, was evaluated and quantified. The revascularization rate was assessed and correlated with the postoperative CAG thickness. No intraoperative and postoperative complications occurred. Reperfusion of the CAGs was observed at 1week, and early reperfusion within the first month accounted for more than half of graft revascularization. The vessel regrowth density was 9.6±2.6 % and 11.1±2.8 % between 1week and 1month, and was 9.8±1.8 % and 11.9±1.9 % between 1 and 3months, at the CAG and underlying episcleral levels, respectively. All the CAGs were well-perfused at 3months. The vessel regrowth density was significantly and strongly correlated with the changes of CAG thickness in a negative relationship (γ = -0.94, P = 0.019). At the harvested site, the vascular network of episclera was not affected, and the conjunctival vascularization was restored at 1month. OCTA is a promising tool to evaluate the vascularization or revascularization of conjunctiva, conjunctival graft and episclera, in a quantitative and serial manner, helping in diseases diagnosis and treatment monitoring. The graft revascularization rate was predictive of postoperative graft deswelling.

Autologous Blood Versus Suture Conjunctival Limbal Graft as Pterygium Surgery Treatment

&#x0D; &#x0D; &#x0D; Introduction and Objective: &#x0D; A Pterygium is an elevated, superficial, external ocular mass that usually forms over the perilimbal conjungtiva and extends onto the corneal surface. A Pterygium can cause a significant alteration in visual function in advanced cases. It become inflamed, resulting in redness and ocular irritation. Pterygium excision surgery has been using many methods. There are three choices of method to attach the graft: by suturing, fibrin glue or autologous blood. The purpose of this study is to learn about the efficacy of autologous blood versus suturing conjungtival limbal graft (CLG) on pterygium excision surgery &#x0D; Methods: &#x0D; Retrospective study of 18 patients underwent Pterygium excision surgery with autologous blood gluing compared to suturing the graft. Six patients underwent CLG surgery with suturing and 12 patients were treated with autologous blood gluing. Suturing process was done with nylon 10-0 and the suture was released 7 days after surgery, whereas the graft on the patient with autologous blood CLG was placed and left there for about 10 minutes. Both groups were evaluated after day 1, 1st week, 2nd week and 1st month. Any report of irritating sensation, graft loss, and healing process were recorded thoroughly. Result: &#x0D; Patients with sutured CLG were complaining of uncomfortable sensation on their cornea until one week before suture was released, all grafts were attached until a month. Out of 12 patients with autologous blood CLG method, there were no complain of irritability on cornea until a week, 4 patients lost the graft on the first day, two patients grew granuloma on the second week, 10 patients start healing on the second week. &#x0D; Conclusion: &#x0D; There are still limitations to pterygium excision with autologous blood CLG compared to pterygium excision with CLG suture technique. &#x0D; &#x0D; &#x0D;

Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Objective: To evaluate and compare the efficacy of using conjunctival autograft and non-bare sclera mitomycin C (MMC) techniques as two treatment options for primary pterygium. Patients and Methods: Retrospective comparative study included 55 eyes in 55 patients with primary pterygium. 30 eyes of 30 patients (group 1) underwent pterygium excision followed by conjunctival autograft. 25 eyes of 25 patients (group 2) underwent pterygium removal followed by intraoperative application of 0.02% MMC for 2 minutes with conjunctival preservation (non-bare sclera technique). Both groups were compared in terms of surgery time, pterygium size, cosmetic effect, pterygium recurrence and complications. Results: Mean pterygium size was (3.1 ± 0.64 mm and 2.6 ± 0.94 mm) in group 1 and 2, respectively (p =0.1). Mean surgery time was significantly shorter in MMC group (26.4 ± 6.39 min) as compared to conjunctival autograft group (47.9 ± 11.7 min) (P &lt; 0.0001). Pterygium recurrence was not seen in any of the patients. Mean follow up time was (14.8 ± 6 and 17.2 ± 9.6 months) in group 1 and 2, respectively (p = 0.4). Conclusion: Both conjunctival graft and non-bare sclera MMC techniques are comparable as regard of pterygium recurrence. MMC technique has significantly shorter surgery time, better cosmoses and lower incidence of complications. Preserving the conjunctiva should be considered when the patient has a history of glaucoma or there is insufficient conjunctiva.

Assessment of corneal endothelial cell changes caused by mitomycin-C application during pterygium surgery

Background Topical Mitomycin-C (MMC) can have a deleterious effect onto corneal endothelium in some ophthalmic surgeries. Aim To evaluate safety of intraoperative topical MMC in pterygium surgeries onto corneal endothelium. Design Prospective comparative cohort study. Subjects and methods Forty-six patients were included in this study. Twenty-three patients underwent pterygium surgery with intraoperative MMC application (trial group) and equal number of patients underwent pterygium excision without MMC (control group) at the Suez Canal University Hospital. Corneal endothelial images were acquired with a specular microscope before surgery and at one week, one month, and three months following surgery. Results Mean preoperative endothelial cell counts were 2364±220 cells/mm2 in the pterygium excision without MMC group and 2411±227 cells/mm2 in the pterygium excision with MMC group (P=0.7). One week, one month and three months after surgery, the pterygium with MMC group showed a statistically insignificant endothelial cell loss (P=0.06) whereas the other group didn’t encounter any decrease in ECD (P=0.349), similar insignificant changes were found between the different measurements in the follow-up periods as compared to the preoperative measurements of central corneal thickness (CCT), cellular hexagonality, coefficient of variation and standard deviation of cell area as well as between patients of both groups. Conclusions A single intraoperative 0.02% MMC topical application using MMC solution-moistened cellulose sponges, onto the scleral bed under the conjunctiva with care not to touch the cornea has not resulted in a statistically-significant deleterious effect onto corneal endothelium.

Application of autologous serum eye drops after pterygium surgery: a prospective study.

The study aims to determine the effect of 50% autologous serum drops (ASD) on corneal healing and patient comfort following pterygium surgery. Fifty eyes of 50 patients who underwent pterygium excision combined with autologous conjunctival graft were included in this prospective randomized study: in 25 eyes, 50% ASD. In the remaining 25 eyes, conventional artificial tears (CAT) were applied postoperatively until corneal epithelium had completely epithelialized. Corneal epithelium healing speed, visual analog scale (VAS) for postoperative pain assessment, conjunctival inflammation, and recurrences were evaluated. Patients were followed up for 6months. Mean corneal epithelium closure time was 3.16 ± 0.37days (range 3 and 4days) in ASD group and 4.96 ± 0.84days in CAT group (range 4 and 6days), and the difference was statistically significant (p < 0.001). VAS scores were significantly lower in ASD group than CAT group in the first 5days after surgery. In 9 of 50 eyes, moderate conjunctival inflammation continued 1month: 4 (16%) in ASD group and 5 (20%) in CAT group (p = 0.713). In total, pterygium recurrence was seen in 5 (10%) eyes: 2 eyes (8%) in ASD group and 3 eyes (12%) in CAT group (p = 0.637). ASD accelerated corneal epithelial healing following pterygium surgery. ASD group had lesser pain that was seem to be related with accelerated corneal epithelial healing.

Comparison on the efficacy between two kinds of surgery for pterygium in Taza Area, Morocco

Objective To compare the efficacy between simple excision of pterygium and excision of pterygium combined with corneal limbal stem cells autograft transplantation (LAT) for pterygium in Taza, Morocco. Methods The clinical data of 147 eyes of 133 patients with pterygium from Mar.2015 to Apr.2016 were retrospectively analysed. All patients were divided randomly into group A(control group)and group B(observation group). Group A, 60 eyes of 54 patients, received simple excision of pterygium; group B, 87 eyes of 79 patients underwent excision of pterygium combined with LAT. The recurrence rates were compared between two groups. Results The follow-up time was 3-12 months.The recurrent pterygium of group A at 3 months after surgery occurred in 5 eyes (8.3%) and 3 eyes (3.4%) in group B, the difference was not significant between two groups(χ2=0.834, P=0.361). Six months after surgery, the recurrent pterygium occurred in 11 eyes (18.3%) in group A and 8 eyes (9.2%) in group B, the difference was not significant between two groups(χ2=2.634, P=0.105). At 12 months after surgery, the recurrent pterygium occurred in 16 eyes (26.7%) in group A and 11 eyes (12.6%) in group B, the difference was statistically significant between two groups(χ2=4.567, P=0.031). Conclusion The highest recurrence rate of pterygium happens at 12 months after operation in Taza Area, Morocco. The surgery combined excision of pterygium with LAT is effective with lower recurrence rate. Key words: Pterygium; Limbal stem cells autograft transplantation(LAT); Recurrence rate

Recurrent pterygium treatment using mitomycin C, double amniotic membrane transplantation, and a large conjunctival flap

PurposeThe aim of this study was to evaluate the clinical outcomes of surgery for recurrent pterygia using mitomycin C (MMC), double amniotic membrane transplantation (AMT), and a large conjunctival flap.Patients and methodsThis retrospective case series included 31 eyes in 31 patients with recurrent pterygia. All patients underwent pterygium excision, application of MMC, double AMT, and placement of a large conjunctival flap. Outcome measures were visual acuity, astigmatism, and recurrence. Recurrence was defined as the presence of fibrovascular proliferative tissue crossing the limbus.ResultsThe patients’ mean age was 68.2 years. The mean follow-up period was 3.6 years. The mean preoperative and postoperative best-corrected visual acuities (logMAR conversion) were 0.23 and 0.13, respectively. There was a significant difference between the mean preoperative (−3.85 D) and postoperative (−2.22 D) astigmatism. The recurrence rate was 3.2% (1/31 cases).ConclusionSurgical pterygium excision with application of MMC, double AMT, and placement of a large conjunctival flap was an effective treatment for recurrent pterygia.

Comparative study of astigmatic changes following pterygium excision with conjunctival autograft transplantation

ABSTRACTThis prospective clinical study compared the corneal astigmatism before and after pterygium excision surgery with conjunctival autograft transplantation. The study included 37 eyes of 37 patients diagnosed with pterygium. All participants underwent pterygium excision with conjunctival autograft transplantation and were examined preoperatively and on the first and third month post-intervention. Comprehensive ophthalmic examination was done and measurements included: pterygium size, uncorrected and best corrected visual acuity and corneal astigmatism. Preoperative and postoperative values were compared using the nonparametric Wilcoxon signed-ranks test. The mean pterygium horizontal length was 2.18 mm (range 1–4 mm). A statistically significant correlation was observed between the pterygium length and preoperative astigmatism. The mean corneal astigmatism preoperatively was 1.26 ± 1.18 D and decreased to 0.84 ± 0.73 D three months after the intervention (p < 0.001). The mean UCVA (uncorrected visual acuity) preoperatively was 0.75, improving to 0.77; the mean BCVA (best corrected visual acuity) before surgery was 0.86, improving to 0.87 after the procedure. These results demonstrated that the amount of induced astigmatism increased in proportion to the size of the pterygium increase. The corneal astigmatism tended to decrease significantly following pterygium excision with conjunctival autograft transplantation.

Serratia marcescens endophthalmitis after pterygium surgery: a case report

BackgroundTo report a case of Serratia marcescens endophthalmitis after pterygium surgery using the bare sclera technique with mitomycin C (MMC).Case presentationA 69-year-old male patient underwent pterygium excision surgery using the bare sclera technique and 0.02% MMC. The patient presented with decreased visual acuity and pain from the day after the operation. Trans pars plana vitrectomy was performed and intravitreal antibiotics were administered. Cultures from the aqueous humor and intraocular lens were all positive for S. marcescens, which was sensitive to an empiric antibiotic regimen. The best corrected distant visual acuity, 1 month after treatment, was a finger count/50 cm, but the retinal layer structure and the vasculature were relatively well preserved.ConclusionsThis is the first reported case of S. marcescens endophthalmitis after pterygium surgery. Endophthalmitis caused by S. marcescens has a devastating visual prognosis and may show a high clinical risk-benefit ratio for the application of MMC in pterygium surgery.

Effect of topical cyclopentolate on post‐operative pain after pterygium surgery

ObjectivesThe aim was to evaluate the effectiveness of topical cyclopentolate following pterygium surgery for post‐operative ocular pain.MethodsAll participants had nasal pterygium and underwent pterygium excision and conjunctival autografting with fibrin glue. Participants were randomised into two groups. Participants in group 1 received one per cent cyclopentolate eye drops and artificial tears upon completing surgery and were prescribed self‐administered drops three times daily for three days, while participants in group 2 received a control (artificial tears) in a manner identical to group 1. Data were gathered regarding post‐operative pain intensity experienced during each of the three days. Pain was graded from zero to 10 according to a visual analogue scale, in which zero signified no pain and 10 signified severe, unbearable pain.ResultsThis study analysed data regarding 38 participants in group 1 and 40 participants in group 2. Results were defined as median with interquartile range (IQR); median of the pain scores at days one, two and three were as follows, respectively: 4 (IQR 2), 2.5 (IQR 1) and 2 (IQR 1.25) for group 1 and 5 (IQR 1), 3 (IQR 1.75) and 3 (IQR 1) for group 2. Pain scores were significantly lower for group 1 compared with group 2 at days one, two and three (p < 0.05).ConclusionsTopical cyclopentolate seems to be effective and well tolerated following pterygium surgery for post‐operative ocular pain.

Management of pterygium in a case of post radial keratotomy

&lt;p class="abstract"&gt;&lt;span lang="EN-IN"&gt;This study is a case of post radial keratotomy who underwent pterygium excision and its management&lt;/span&gt;. &lt;span lang="EN-IN"&gt;A 44 old high myope who underwent radial keratotomy more than a decade earlier underwent pterygium excision and conjunctval autograft. 6 months follow-up showed no recurrence of pterygium and improvement in corneal irregulalrity&lt;/span&gt;. &lt;span lang="EN-IN"&gt;Careful and meticulous dissection of pterygium over keratotomy wounds helps in prevention seroius complications during surgery. &lt;/span&gt;&lt;/p&gt;