Excimer laser phototherapeutic keratectomy for recurrent pterygium

Talu, Haluk; Taşındı, Emrullah; Çiftçi, Faruk; Yildiz, Taner Fazil

doi:10.1016/s0886-3350(98)80223-x

Cited by 32 publications

(23 citation statements)

References 24 publications

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“…They reported a recurrence rate of 91% while 3 years later, Förster et al [30,31] reported about 33-57% in two series of 50 and 46 eyes. Talu et al [32] reported a 4.5% recurrence rate, while Walkow et al [33] observed a significantly reduced astigmatism in a series of 60 eyes that had undergone bare-sclera resection combined with excimer smoothing. They also suggested the postoperative use of locally applied mitomycin C, which they report yielded a recurrence rate of 5% [34,35].…”

Section: Discussionmentioning

confidence: 99%

Pterygium Recurrence, Astigmatism and Visual Acuity following Bare-Sclera Excision and Conjunctival Autograft with or without Additional Phototherapeutic Keratectomy

Promesberger¹,

Kohli²,

Busse³

et al. 2013

Ophthalmic Res

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Background: Treatment outcome in patients with pterygium following bare-sclera excision and conjunctival autograft (CAG) with and without phototherapeutic keratectomy (PTK). Methods: Retrospective comparative analysis of 81 eyes, with primary and recurrent pterygia, that were analyzed for recurrence, best-corrected visual acuity (BCVA) and astigmatism in primary (P1 without PTK, P2 with PTK) and recurrent pterygia (R1 without PTK, R2 with PTK). BCVA and astigmatism were compared in patients with simple CAG alone (group I) or in combination with PTK (group II). Results: Recurrence rates were 4.7, 11.6, 16.2, 23.2 and 32.5% at 3, 6, 12, 24 and >24 months (P1), 7.1% at >24 months (P2). Recurrence rates were 5.3, 10.5, 21.1, 21.1 and 26.3% at 3, 6, 12, 24 and >24 months (R1) and 1 recurrence (7.7%) till month 24, and 3 (23.1%) thereafter (R2). BCVA increased from logarithm of the minimal angle of resolution 0.095 ± 0.141 (mean ± SD) at baseline to 0.066 ± 0.09 (group I), and from 0.090 ± 0.164 to 0.054 ± 0.124 (group II). Astigmatism decreased from -1.01 ± 0.90 dpt at baseline to -0.97 ± 1.24 dpt (group I), and from -1.19 ± 1.55 to -0.75 ± 0.87 dpt (group II). Conclusion: In comparison to CAG alone, additional excimer smoothing with PTK tends to increase BCVA and reduces recurrence rates in patients with primary pterygia.

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Section: Discussionmentioning

confidence: 99%

Pterygium Recurrence, Astigmatism and Visual Acuity following Bare-Sclera Excision and Conjunctival Autograft with or without Additional Phototherapeutic Keratectomy

Promesberger¹,

Kohli²,

Busse³

et al. 2013

Ophthalmic Res

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“…The use of more sophisticated conjunctival surgery is associated with considerably lower recurrence rates, often less than 10% (16,78). Other modalities for pterygium removal, such as ablation with excimer laser, have not gained widespread acceptance, although excimer laser may have a role in smoothening corneal surface irregularities caused by pterygium (81,82). However, lamellar karatoplasty may also be required, especially in cases of recurrent pterygia with firm adhesion to the corneal stroma (83).…”

Section: Treatment Optionsmentioning

confidence: 99%

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Detorakis

Spandidos²

2009

Int J Mol Med

150

103

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Abstract. Pterygium is a fibrovascular lesion of the ocular surface that can display an aggressive clinical behavior and, occasionally, threaten vision. Although there is no consensus on its pathogenesis, recent evidence suggests that it is a proliferative, rather than degenerative condition strongly correlated with exposure to ultraviolet radiation (UVR) of solar light. Molecular genetic alterations reported in association with pterygium include loss of heterozygosity (LOH), point mutations of proto-oncogenes, such as K-ras and alterations in the expression of tumor suppressor genes, such as p53 or p63. Other findings in pterygium include the frequent detection of HPV DNA, ocular surface changes such as the overexpression of various proteins, including defensins and phospolipases D, as well as the up-regulation of growth factors, such as bFGF or VEGF. Although pterygium management has traditionally involved surgery, often enhanced by the use of antimetabolites, recent advancements in the understanding of molecular and biochemical events underlying pterygium pathogenesis may enable the use of less invasive treatment methods.

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“…Over the past few decades, several surgical methods for pterygium have emerged, ranging from the bare sclera procedure without microscopy to very complex approaches such as amniotic membrane transplantation and lamellar keratoplasty [1, 2]. Some adjunct therapies also are used such as beta-radiation, excimer laser and antimetabolites to lower the recurrence rates, but these may sometimes be associated with severe complications [3,4,5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Comparison of Fibrin Sealant and Sutures for Conjunctival Autograft Fixation in Pterygium Surgery: One-Year Follow-Up

Jin

Yang²,

Zhang³

et al. 2008

Ophthalmologica

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Aims: To evaluate the efficacy and safety of fibrin sealant in conjunctival autograft fixation in pterygium surgery. Methods: Prospective, comparative, interventional case series. 40 eyes of 40 patients with nasal primary pterygium, 24 male and 16 female, were enrolled. The patients were assigned to two groups and each contained 12 male and 8 female based on the pterygium area encroaching onto the cornea. In one group the conjunctival autograft was attached to the sclera with fibrin sealant and the other group with nylon 10–0 sutures. All the patients were followed up postoperatively on days 1, 3, 7 and 14 then at months 1, 2, 6 and 12. The main outcome measures included operating time, postoperative symptoms, graft success, recurrence rate and complications. Results: The average operating time was significantly shorter (p < 0.001) in the fibrin sealant group and fewer postoperative symptom complaints were received as well. By the end of 1-year follow-up, the recurrence rate was 5% in the fibrin sealant group and 10% in the suture group (p = 1.000), and there was no statistically significant difference in complications (p > 0.05) between the two groups. Conclusions: It is safe and effective to use fibrin sealant for conjunctival autograft fixation. This method causes much fewer postoperative symptoms and shortens surgery time significantly, and the long-term results are also favorable.

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Excimer laser phototherapeutic keratectomy for recurrent pterygium

Cited by 32 publications

References 24 publications

Pterygium Recurrence, Astigmatism and Visual Acuity following Bare-Sclera Excision and Conjunctival Autograft with or without Additional Phototherapeutic Keratectomy

Pterygium Recurrence, Astigmatism and Visual Acuity following Bare-Sclera Excision and Conjunctival Autograft with or without Additional Phototherapeutic Keratectomy

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Comparison of Fibrin Sealant and Sutures for Conjunctival Autograft Fixation in Pterygium Surgery: One-Year Follow-Up

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