PTERJİYUM CERRAHİ TEDAVİSİ

Year 2019, , 1642 - 1651, 15.08.2019

Ali Şimşek , Lokman Balyen , Müslüm Toptan , Ayhan Sağlar Ali Asgar Yetkin

https://doi.org/10.30569/adiyamansaglik.596458

Abstract

Pterjium,
konjonktivanın kornea üzerine fibrovasküler uzanım göstermesi ile karakterize,
dejeneratif ve proliferatif bir oküler
yüzey hastalığıdır. Pterjium
cerrahi olarak çıkarılmasını gerektirebilecek neoplastik olmayan konjonktiva büyümeleridir.
Pterjium eksizyondan sonra tekrarlayabilir. Pterjium tedavisinin asıl amacı tekrarlamadan kaçınmaktır, ancak komplikasyon oranları
ve kozmetik sonuçlar
da göz önünde bulundurulmalıdır.
Mevcut tekniklerin çokluğuna rağmen, en iyi prosedür konusunda fikir birliği yoktur.
En iyi teknikler bile nüks ve
komplikasyon riskini taşır. Bu çalışmamızda, güncel cerrahi kullanımda farklı
cerrahi teknikler, greft tutturma yöntemleri ve adjuvan tedaviler
tartışılmıştır. Ayrıca, önerilen bir tedavi olmadan önce daha fazla araştırma
gerektiren yeni teknikler tartışılmıştır. Bu gözden geçirme, hipotez oluşturma
konusunda araştırmacılara yardım etmek ve cerrahlara kararları hakkında bilgi
vermek için mevcut araştırmaları gözden geçirmeyi amaçlamaktadır.

Keywords

Adjuvan tedavi, Pterygium, Konjonktival otogreft, nüks

Supporting Institution

YOK

SURGICAL TREATMENT OF PTERYGIUM

Abstract

Pterygium
is a degenerative and proliferative ocular surface disease characterized by
fibrovascular extension of the conjunctiva on the cornea. Pterygium is a
non-neoplastic conjunctival enlargement that may require surgical removal. The
pterygium may recur after excision. The main goal of pterygium treatment is to
avoid recurrence, but complications and cosmetic outcomes should also be
considered. Despite the plenty of available techniques, there is no consensus on
the best procedure. Even the best techniques carry a risk of recurrence and
complications. In this study, different surgical techniques, graft fixation
methods and adjuvant therapies are discussed. Furthermore, new techniques that
require further research were discussed before becoming a proposed treatment.
The review aims to review existing research to assist researchers in creating
hypotheses and to inform surgeons about their decisions.

Keywords

Adjuvant therapy, Conjunctival autograft, Pterygium, Recurrence

References

• 1. Li Z. Prevalence and associated factors for pterygium in a rural adult population (the Southern Harbin Eye Study). Cornea 2013;32:806-9.
• 2. Gazzard G, Saw SM, Farook M, et al. Pterygium in Indonesia: prevalence, severity and risk factors. Br J Ophthalmol 2002;86:1341-6.
• 3. Kurna SA, Altun A, Aksu B, et al. Comparing treatment options of pterygium: limbal sliding flap transplantation, primary closing, and amniotic membrane grafting. Eur J Ophthalmol 2013;23:480-7.
• 4. Al Fayez MF. Limbal-conjunctival vs conjunctival autograft transplant for recurrent pterygia: a prospective randomized controlled trial. JAMA Ophthalmol 2013;131:11-6.
• 5.Tomidokoro A., Miyata K., Sakaguchi Y., Samejima T., Tokunaga T., Oshika T. Effects of Pterygium on Corneal Spherical Power and Astigmatism. Ophthalmology. 2000 ;107(8):1568-71.
• 6. Alpay A, Ugurbas¸ S, Erdogan B. Comparing techniques for pterygium surgery. Clin Ophthalmol 2009;3:69-74.
• 7. Julio G, Lluch S, Pujol P, Merindano D. Ocular discomfort in pterygium patients. Optom Vis Sci 2013;90:269-74.8. Turkyilmaz K, Oner V, Sevin M, et al. Effect of pterygium surgery on tear osmolarity. J Ophthalmol 2013;2013:1-5.
• 9. Varssano D, Shalev H, Lazar M, Fischer N. Pterygium excision with conjunctival autograft: True survival rate statistics. Cornea 2013;32:1243-50.
• 10. Kaufman S, Jacobs D, Lee W, et al. Options and adjuvants in surgery for pterygium: a report by the American Academy of Ophthalmology. Ophthalmology 2013;120:201-8.
• 11. Ma D, See L-C, Liau S, Tsai R. Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment. Br J Ophthalmol 2000;84:973-8.
• 12. Mahar PS, Manzar N. The study of etiological and demographic characteristics of pterygium recurrence: a consecutive case series study from Pakistan. Int Ophthalmol 2013. June 18:Epub ahead of print.
• 13. Varssano D, Shalev H, Lazar M, Fischer N. Pterygium excision with conjunctival autograft: True survival rate statistics. Cornea 2013;32:1243-50.
• 14. Hirst L, Sebban A, Chant D. Pterygium recurrence time. Ophthalmology 1994;101:755-8.15. Adamis AP,Starck T,Kenyon KR.The management of ptergium Ophthalmol.Cli North Am 1990;3(4):611-23.
• 16. Li M, Zhu M, Yu Y, et al. Comparison of conjunctival autograft transplantation and amniotic membrane transplantation for pterygium: a meta-analysis. Graefes Arch Clin Experiment Ophthalmol 2012;250:375-81.
• 17. Jain V, Shome D, Natarajan S, Narverkar R. Surgically induced necrotizing scleritis after pterygium surgery with conjunctival autograft. Cornea 2008;27:720-1.
• 18. Farid M, Pirnazar J. Ptergyium recurrence after excision with conjunctival autograft: a comparison of fibrin tissue adhesive to absorbable sutures. Cornea 2009;28:43-5.
• 19. Koranyi G, Artzén D, Wijk T. Learning curve in the Cut and Paste method for surgery of primary pterygium. Acta Ophthalmol Scand 2012. Mar 9:1-6.
• 20. Shehadeh-Mashor R, Srinivasan S, Boimer C, et al. Management of recurrent pterygium with intraoperative mitomycin C and conjunctival autograft with fibrin glue. Am J Ophthalmol 2011;152:730-2.
• 21. Ozer A, Yildirim N, Erol N, Yurdakul S. Long-term results of bare sclera, limbal-conjunctival autograft and amniotic membrane graft techniques in primary pterygium excisions. Ophthalmologica 2009;223:269-73.
• 22. Kheirkhah A, HashemiH, Adelpour M, et al. Randomized trial of pterygium surgery with mitomycin c application using conjunctival autograft versus conjunctival-limbal autograft. Ophthalmology 2012;119(2):27-32.
• 23. Welder JD, Pandya HK, Nassiri N, Djalilian AR. Conjunctival limbal autograft and allograft transplantation using fibrin glue. Ophthalmic Surg Lasers Imaging 2012;43:323-7.
• 24. Mandour SS, Farahat HG, Mohamed HM. Preoperative subpterygial mitomycin C injection versus limbal conjunctival autograft transplantation for prevention of pterygium recurrence. J Ocul Pharmacol Ther 2011;27:481-5.
• 25. Kim M, Chung S, Lee J, et al. Comparison of mini-flap technique and conjunctival autograft transplantation without mitomycin C in primary and recurrent pterygium. Ophthalmologica 2008;222:265-71.
• 26. Benyamini O, Barkana Y, Hartstein M, et al. Biological glue in pterygium surgery with a rotational flap or sliding flaps. Cornea 2008;27:911-5.
• 27. Solomon A, Pires R, Tseng S. Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia. Ophthalmology 2001;108:449-60.
• 28. Shimazaki J, Shinozaki N, Tsubota K. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol 1998;82:235-40.
• 29. Cha D, Kim K, Choi J, et al. A comparative study of the effect of fibrin glue versus sutures on clinical outcome in patients undergoing pterygium excision and conjunctival autografts. Korean J Ophthalmol 2012;26:407-13.
• 30. Por YM, Tan DT. Assessment of fibrin glue in pterygium surgery. Cornea 2010;29:1-4.
• 31. Koranyi G, Seregard S, Kopp E. The cut-and-paste method for primary pterygium surgery. Acta Ophthalmol Scand 2005;83:298-301.
• 32. Oswald A, Joly L, Gury C, et al. Fatal intraoperative anaphylaxis related to aprotinin after local application of fibrin glue. Anesthesiology 2003;99:762-3.
• 33. Singh PK, Singh S, Vyas C, Singh M. Conjunctival autografting without fibrin glue or sutures for pterygium surgery. Cornea 2013;32:104-7.
• 34. Xu F, Li M, Yan Y, et al. A novel technique of sutureless and glueless conjunctival autografting in pterygium surgery by electrocautery en. Cornea 2013;32:290-5.
• 35. Engle AT, Laurent JM, Schallhorn SC, et al. Masked comparison of silicone hydrogellotrafilcon A and etafilcon A extended-wear bandage contact lenses after photorefractive keratectomy. J Cataract Refract Surg. 2005;31:681–6.
• 36. Gil-Casorla R, Teus MA, Hernandes-Verdejo JL, et al. Comparative study of two silicone hydrogel contact lenses used as bandage contact lenses after LASEK. Optom Vis Sci. 2008;85:884–8.
• 37. Hirst LW. Prospective study of primary pterygium surgery using pterygium extended removal followed by extended conjunctival transplantation. Ophthalmology. 2008;115:1663–72.
• 38. Hirst LW. Recurrent pterygium surgery using pterygium extended removal followed by extended conjunctival transplant: recurrence rate and cosmesis. Ophthalmology. 2009;116:1278–86.