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Comparison of different surgical techniques in the treatment of pterygium

Year 2012, Volume: 18 Issue: 3, 160 - 165, 01.04.2012

Abstract

This study was done to compare the rates of recurrence of pterygium following performed different surgical techniques for treatment. One hundred and thirty eyes of 128 patients were examined following the surgical treatment in our clinic between February 2004- January 2008 with mean follow-up of six months. We performed bare sclera, application of intraoperative MMC (Mitomycin C), wide tenon’s membrane excision and conjunctival auto-grafting techniques. The age and sex of the patients and follow-up duration, operation techniques, complications and the recurrence times were noted. Median follow-up was 9,42±3,93 months and the recurrence rate was %25,4. The highest recurrence rate was %55,2 (in the bare sclera technique), the lowest recurrence rate was %13,5 (in the intraoperative MMC technique). It was %14,6 in conjunctival auto-grafting technique group and %31,3 in the complete tenon’s membrane excision group. Statistically, the rate of recurrence was meaningful between the bare sclera group and the conjunctival autografting group and between intraoperative MMC group. But the outcomes of the wide tenon’s membrane excision group and the other three groups weren’t meaningful. Bare sclera technique had the highest recurrence rates. Though, there wasn’t meaningful recurrence rates between intraoperative MMC technique and the conjunctival auto-grafting technique, we must prefer the second one because of its lowest complication risks. The wide tenon’s membrane excision technique needs some more studies to compare the others.

References

  • 1. McCarty CA, Fu CL, Taylor HR. Epidemiology of pterygium in Victoria, Australia. Br J Ophthalmol. 2000;84(3):289-92.
  • 2. Threlfall TJ, English DR.Sun exposure and pterygium of the eye: a dose-response curve. Am J Ophthalmol 1999;128(3):280- 7.
  • 3. Hirst LW, Sebban A, Chant D. Pterygium recurrence time. Ophthalmology 1994;101(4):755-8.
  • 4. Chen PP, Ariyasu RG, Kaza V, LaBree LD, McDonnell PJ. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120(2):151-60.
  • 5. Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 1997;115(10):1235-40. Erratum in: Arch Ophthalmol 1998 Apr;116(4):552.
  • 6. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104(6):974-85.
  • 7. Taylor HR, West S, Muñoz B, Rosenthal FS, Bressler SB, Bressler NM. The long-term effects of visible light on the eye. Arch Ophthalmol 1992;110(1):99-104.
  • 8. Anduze AL. Merest sclera technique for primary pterygium surgery. Ophthalmic Surg 1989;20(12):892-4.
  • 9. Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD, Kirkness CM. Conjunctival autografting in the surgical management of pterygium Eye 1993;7:634-8.
  • 10. Singh G, Wilson MR, Foster CS. Mitomycin eye drops as treatment for pterygium. Ophthalmology 1988;95(6):813-21.
  • 11. Mikaniki E, Rasolinejad SA. Simple excision alone versus simple excision plus mitomycin C in the treatment of pterygium. Ann Saudi Med 2007;27(3):158-60.
  • 12. Saifuddin S, Baum KL. Recurrent pterygia. laser therapy: a preliminary report. Indian J Ophthalmol 1993;41(1):17-9.
  • 13. Cano-Parra J, Diaz-Llopis M, Maldonado MJ, Vila E, Menezo JL. Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium. Br J Ophthalmol 1995;79(5):439-41.
  • 14. Alsagoff Z, Tan DT, Chee SP. Necrotising scleritis after bare sclera excision of pterygium. Br J Ophthalmol 2000;84(9):1050- 2.
  • 15. Kenyon KR, Wagoner MD, Hettinger ME.Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985;92(11):1461-70.
  • 16. Hirst LW. The Treatment Of Pterygium. Survey of Ophthalmology 2003;48:145-180.
  • 17. Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD, Kirkness CM. Conjunctival autografting in the surgical management of pterygium Eye 1993;7:634-8.

Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması

Year 2012, Volume: 18 Issue: 3, 160 - 165, 01.04.2012

Abstract

Çalışmamızda pterjium cerrahisinde uygulanan farklı cerrahi teknikler arasında nüks oranlarının araştırılması amaçlandı. Çalışmaya ameliyat sonrası en az 6 ay takibi bulunan, 128 hastanın 130 gözü alındı. Hastalara cerrahi yöntem olarak çıplak sklera bırakılması, intraoperatif MMC (Mitomisin C) uygulaması, geniş tenon eksizyonu ve konjonktival otogreft uygulaması yöntemleri uygulandı. Hastaların yaşı, cinsiyeti, takip süreleri, uygulanan cerrahi prosedür, nüks gelişme zamanları ve komplikasyonlar not edildi. Sonrasında hesaplanan nüks oranları istatistiksel olarak analiz edildi. Ortalama 9,42±3,93 ay takip edilen hastaların %25,4’ünde nüks saptandı. En yüksek nüks oranı %55,2 ile çıplak sklera tekniğinde tespit edildi. Konjonktival otogreft uygulamasında %14,6, intraoperatif MMC uygulamasında %13,5, geniş tenon eksizyonunda %31,3 oranında nüks görüldü. Çıplak sklera bırakılması ile konjonktival otogreft uygulaması ve intraoperatif MMC uygulaması arasında nüks açısından anlamlı fark saptanırken, geniş tenon eksizyonu ile diğer 3 yöntem arasında nüks bakımından farklılık saptanmadı. Çıplak sklera bırakılması diğer yöntemlerden yüksek nüks oranlarına sahiptir. Birbirine yakın düşük nüks oranları mevcut olsa da potansiyel komplikasyonlar göz önüne alındığında konjonktival otogreft yöntemi, intraoperatif MMC uygulamasına tercih edilmelidir. Geniş tenon eksizyonunun diğer yöntemlerle kıyaslanması için geniş vaka grupları ile yapılacak çalışmalara ihtiyaç vardır.

References

  • 1. McCarty CA, Fu CL, Taylor HR. Epidemiology of pterygium in Victoria, Australia. Br J Ophthalmol. 2000;84(3):289-92.
  • 2. Threlfall TJ, English DR.Sun exposure and pterygium of the eye: a dose-response curve. Am J Ophthalmol 1999;128(3):280- 7.
  • 3. Hirst LW, Sebban A, Chant D. Pterygium recurrence time. Ophthalmology 1994;101(4):755-8.
  • 4. Chen PP, Ariyasu RG, Kaza V, LaBree LD, McDonnell PJ. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol 1995;120(2):151-60.
  • 5. Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 1997;115(10):1235-40. Erratum in: Arch Ophthalmol 1998 Apr;116(4):552.
  • 6. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 1997;104(6):974-85.
  • 7. Taylor HR, West S, Muñoz B, Rosenthal FS, Bressler SB, Bressler NM. The long-term effects of visible light on the eye. Arch Ophthalmol 1992;110(1):99-104.
  • 8. Anduze AL. Merest sclera technique for primary pterygium surgery. Ophthalmic Surg 1989;20(12):892-4.
  • 9. Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD, Kirkness CM. Conjunctival autografting in the surgical management of pterygium Eye 1993;7:634-8.
  • 10. Singh G, Wilson MR, Foster CS. Mitomycin eye drops as treatment for pterygium. Ophthalmology 1988;95(6):813-21.
  • 11. Mikaniki E, Rasolinejad SA. Simple excision alone versus simple excision plus mitomycin C in the treatment of pterygium. Ann Saudi Med 2007;27(3):158-60.
  • 12. Saifuddin S, Baum KL. Recurrent pterygia. laser therapy: a preliminary report. Indian J Ophthalmol 1993;41(1):17-9.
  • 13. Cano-Parra J, Diaz-Llopis M, Maldonado MJ, Vila E, Menezo JL. Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium. Br J Ophthalmol 1995;79(5):439-41.
  • 14. Alsagoff Z, Tan DT, Chee SP. Necrotising scleritis after bare sclera excision of pterygium. Br J Ophthalmol 2000;84(9):1050- 2.
  • 15. Kenyon KR, Wagoner MD, Hettinger ME.Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology 1985;92(11):1461-70.
  • 16. Hirst LW. The Treatment Of Pterygium. Survey of Ophthalmology 2003;48:145-180.
  • 17. Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD, Kirkness CM. Conjunctival autografting in the surgical management of pterygium Eye 1993;7:634-8.
There are 17 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ferhat Zorlu This is me

Pervin Çınar This is me

Enis Fırıncıoğulları This is me

Emrah Mat This is me

Publication Date April 1, 2012
Published in Issue Year 2012 Volume: 18 Issue: 3

Cite

APA Zorlu, F., Çınar, P., Fırıncıoğulları, E., Mat, E. (2012). Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması. Gaziantep Medical Journal, 18(3), 160-165.
AMA Zorlu F, Çınar P, Fırıncıoğulları E, Mat E. Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması. Gaziantep Medical Journal. April 2012;18(3):160-165.
Chicago Zorlu, Ferhat, Pervin Çınar, Enis Fırıncıoğulları, and Emrah Mat. “Pterjium Tedavisinde Farklı Cerrahi Tekniklerin karşılaştırılması”. Gaziantep Medical Journal 18, no. 3 (April 2012): 160-65.
EndNote Zorlu F, Çınar P, Fırıncıoğulları E, Mat E (April 1, 2012) Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması. Gaziantep Medical Journal 18 3 160–165.
IEEE F. Zorlu, P. Çınar, E. Fırıncıoğulları, and E. Mat, “Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması”, Gaziantep Medical Journal, vol. 18, no. 3, pp. 160–165, 2012.
ISNAD Zorlu, Ferhat et al. “Pterjium Tedavisinde Farklı Cerrahi Tekniklerin karşılaştırılması”. Gaziantep Medical Journal 18/3 (April 2012), 160-165.
JAMA Zorlu F, Çınar P, Fırıncıoğulları E, Mat E. Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması. Gaziantep Medical Journal. 2012;18:160–165.
MLA Zorlu, Ferhat et al. “Pterjium Tedavisinde Farklı Cerrahi Tekniklerin karşılaştırılması”. Gaziantep Medical Journal, vol. 18, no. 3, 2012, pp. 160-5.
Vancouver Zorlu F, Çınar P, Fırıncıoğulları E, Mat E. Pterjium tedavisinde farklı cerrahi tekniklerin karşılaştırılması. Gaziantep Medical Journal. 2012;18(3):160-5.