Purpose: To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium. Methods: This random control study included 63 patients (63...Purpose: To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium. Methods: This random control study included 63 patients (63 eyes) with primary pterygium. These were randomly divided into a group with corneal limbal conjunctival autograft combined with pterygium excision (group A) and a group with pterygium excision with exposed sclera (group B) and subjected to long-term follow up. The surgical outcomes were classified and evaluated (grade Ⅰ-Ⅳ). Several indexes were analyzed, including ocular surface irritation symptom,tear film stability, surgical complication, and recurrence rate. Results: The follow up ranged from 24 to 38 months, (26.9± 3.4) months on average. No recurrence was noted at 6 weeks postoperatively. At 6 months postoperatively, the recurrence rate of pterygium was 5.2% in group A and 8.0% in group B. At 1 year postoperatively, the recurrence rate in group A was 10.5% and 20.0% in group B. At the end of follow up, the recurrence rates were 13.1% in group A and 24.0% in group B. No statistical significance was found between two groups regarding the recurrence rates at each time point (P>0.05). After the follow up. (> 2 years),the severity of ocular surface conditions was significantly milder in patients in group A than in group B (P <0.01).No statistically significant differences were noted between the two groups at 6 weeks,6 months, and 1 year after surgery. No statistically significant differences were observed between the two groups regarding postoperative tear film break-up time. Fewer postoperative complications and milder ocular surface irritation symptoms occurred in patients in group A. Conclusion: Corneal limbal conjunctival autograft combined with pterygium excision yields sound long-term efficacy and a low recurrence rate and induces only mild damage on the ocular surface when used as a treatment for pterygium.展开更多
Purpose:To compare the complications and the recurrence rate between fibrin glue (TISSEEL) and Vicryl 8-0 sutures in amniotic membrane transplant during pterygium surgery.Methods:Patients who underwent pterygium surge...Purpose:To compare the complications and the recurrence rate between fibrin glue (TISSEEL) and Vicryl 8-0 sutures in amniotic membrane transplant during pterygium surgery.Methods:Patients who underwent pterygium surgery with amniotic membrane transplant (AMT) in the Wang Eye Clinic (Doraville,USA).were randomly categorized into two groups:one group received TISSEEL and the other group received Vicryl 8-0 sutures.All procedures for both groups were performed by one ophthalmologist.Twenty-four patients (24 eyes) participated in the TISSEEL group (22 eyes with primary surgery and 2 eyes with surgery for recurrence) and 19 patients (19 eyes) took part in the suture group (18 primary eyes and 1 recurrence).The patients with recurrent pterygium in both groups had not received AMT previously.Post-operatively,patients were followed up for one week and then one year to check for any signs of complications and recurrence.Results:Conjunctival inflammation occurred in 3 eyes (12.5%) in the TISSEEL group,and 6 eyes (31.6%) in the suture group.(P<0.05,Chi-square test).In the TISSEEL group,1 eye (4.2%) showed recurrence,while there were no recurrences in the sutures group.There were 3 dry eyes (15.8%) in the suture group and 2 dry eyes (8.3%) in the TISSEEL group (P>0.05).No dislocated conjunctival grafts,Dellen,inflammation,infection,bleeding,pyogenic granuloma,or scleromalacia was observed in either group.Conclusion:Pterygium surgery with AMT had less conjunctival inflammation and dry eye in patients receiving fibrin glue than those with Vicryl 8-0 sutures.展开更多
Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study...Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation （ACT） versus mitomycin C （MMC）. Methods Relevant literature published until December 2010 in Medline, Embase, Cochrane, Cochrane library, Science Citation Index, and Google Scholar were searched. Qualified random clinical trial （RCT） studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study. Results Eight RCTs with 663 eyes entered the final analysis. The recurrent rate of pterygium was 8.7% （30/343） for ACT and 18.75% （60/320） for MMC. Using fixed-effect meta analysis, we found that the recurrence was significantly lower after ACT than MMC treatment （odds ratio （OR）=0.40, 95% confidence index （C/）, 0.25-0.63, P 〈0.0001）. In sensitivity analyses, we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation. All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC. Sub-group analysis revealed that the recurrence rate was 20.2% （20/99） and 27.65% （26/94） for conjunctival autograft （CA） and MMC respectively, and no significant difference in the recurrence rate was detected （OR=0.65, 95% CI 0.33-1.28, P=0.22）. However, we found that conjunctival limbal autograft （CLA） had lower recurrence rate than MMC （OR=0.26, 95% CI 0.14-0.48, P=0.0001）.展开更多
文摘Purpose: To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium. Methods: This random control study included 63 patients (63 eyes) with primary pterygium. These were randomly divided into a group with corneal limbal conjunctival autograft combined with pterygium excision (group A) and a group with pterygium excision with exposed sclera (group B) and subjected to long-term follow up. The surgical outcomes were classified and evaluated (grade Ⅰ-Ⅳ). Several indexes were analyzed, including ocular surface irritation symptom,tear film stability, surgical complication, and recurrence rate. Results: The follow up ranged from 24 to 38 months, (26.9± 3.4) months on average. No recurrence was noted at 6 weeks postoperatively. At 6 months postoperatively, the recurrence rate of pterygium was 5.2% in group A and 8.0% in group B. At 1 year postoperatively, the recurrence rate in group A was 10.5% and 20.0% in group B. At the end of follow up, the recurrence rates were 13.1% in group A and 24.0% in group B. No statistical significance was found between two groups regarding the recurrence rates at each time point (P>0.05). After the follow up. (> 2 years),the severity of ocular surface conditions was significantly milder in patients in group A than in group B (P <0.01).No statistically significant differences were noted between the two groups at 6 weeks,6 months, and 1 year after surgery. No statistically significant differences were observed between the two groups regarding postoperative tear film break-up time. Fewer postoperative complications and milder ocular surface irritation symptoms occurred in patients in group A. Conclusion: Corneal limbal conjunctival autograft combined with pterygium excision yields sound long-term efficacy and a low recurrence rate and induces only mild damage on the ocular surface when used as a treatment for pterygium.
文摘Purpose:To compare the complications and the recurrence rate between fibrin glue (TISSEEL) and Vicryl 8-0 sutures in amniotic membrane transplant during pterygium surgery.Methods:Patients who underwent pterygium surgery with amniotic membrane transplant (AMT) in the Wang Eye Clinic (Doraville,USA).were randomly categorized into two groups:one group received TISSEEL and the other group received Vicryl 8-0 sutures.All procedures for both groups were performed by one ophthalmologist.Twenty-four patients (24 eyes) participated in the TISSEEL group (22 eyes with primary surgery and 2 eyes with surgery for recurrence) and 19 patients (19 eyes) took part in the suture group (18 primary eyes and 1 recurrence).The patients with recurrent pterygium in both groups had not received AMT previously.Post-operatively,patients were followed up for one week and then one year to check for any signs of complications and recurrence.Results:Conjunctival inflammation occurred in 3 eyes (12.5%) in the TISSEEL group,and 6 eyes (31.6%) in the suture group.(P<0.05,Chi-square test).In the TISSEEL group,1 eye (4.2%) showed recurrence,while there were no recurrences in the sutures group.There were 3 dry eyes (15.8%) in the suture group and 2 dry eyes (8.3%) in the TISSEEL group (P>0.05).No dislocated conjunctival grafts,Dellen,inflammation,infection,bleeding,pyogenic granuloma,or scleromalacia was observed in either group.Conclusion:Pterygium surgery with AMT had less conjunctival inflammation and dry eye in patients receiving fibrin glue than those with Vicryl 8-0 sutures.
文摘Background The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation （ACT） versus mitomycin C （MMC）. Methods Relevant literature published until December 2010 in Medline, Embase, Cochrane, Cochrane library, Science Citation Index, and Google Scholar were searched. Qualified random clinical trial （RCT） studies on the comparison of recurrence rate of pterygium after ACT and MMC treatment were included in this study. Results Eight RCTs with 663 eyes entered the final analysis. The recurrent rate of pterygium was 8.7% （30/343） for ACT and 18.75% （60/320） for MMC. Using fixed-effect meta analysis, we found that the recurrence was significantly lower after ACT than MMC treatment （odds ratio （OR）=0.40, 95% confidence index （C/）, 0.25-0.63, P 〈0.0001）. In sensitivity analyses, we employed random-effects model and excluded studies of low quality or studies in which MMC was administrated after the operation. All the sensitivity analyses confirmed that ACT led to lower recurrence rates than MMC. Sub-group analysis revealed that the recurrence rate was 20.2% （20/99） and 27.65% （26/94） for conjunctival autograft （CA） and MMC respectively, and no significant difference in the recurrence rate was detected （OR=0.65, 95% CI 0.33-1.28, P=0.22）. However, we found that conjunctival limbal autograft （CLA） had lower recurrence rate than MMC （OR=0.26, 95% CI 0.14-0.48, P=0.0001）.
