Postoperative Subconjunctival Corticosteroid Injection to Prevent Pterygium Recurrence

Paris, Fabiana dos Santos; Farias, Charles Costa de; Melo, Gustavo Barreto; Santos, Myrna Serapião dos; Batista, Jefferson Luiz Alves; Gomes, José Álvaro Pereira

doi:10.1097/ico.0b013e318162af90

Cited by 31 publications

(17 citation statements)

References 20 publications

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“…We excluded two studies because they were not RCTs (Liu 2014; Yan 2010). We excluded four studies because it was unclear whether participants were randomized to the type of surgery they received (Katircioglu 2007; Kim 2008; Ozkurt 2009; Paris 2008). We attempted to contact the authors of these four studies to ask whether their participants were randomized, but received no response, so we chose to exclude them.…”

Section: Resultsmentioning

confidence: 99%

Conjunctival autograft for pterygium

Clearfield

Muthappan

Wang

et al. 2016

Cochrane Database of Systematic Reviews

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Background A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. Prevalence ranges widely around the world. Evidence suggests that ultraviolet light is a major contributor in the formation of pterygia. Pterygia impair vision, limit eye movements, and can cause eye irritation, foreign body sensation, and dryness. In some susceptible patients, the pterygium can grow over the entire corneal surface, blocking the visual axis. Surgery is the only effective treatment for pterygium, though recurrences are common. With simple excision techniques (that is, excising the pterygium and leaving bare sclera), the risk of recurrence has been reported to be upwards of 80%. Pterygium excision combined with a tissue graft has a lower risk of recurrence. In conjunctival autograft surgery, conjunctival tissue from another part of the person’s eye along with limbal tissue is resected in one piece and used to cover the area from which the pterygium was excised. Another type of tissue graft surgery for pterygium is amniotic membrane graft, whereby a piece of donor amniotic membrane is fixed to the remaining limbus and bare sclera area after the pterygium has been excised. Objectives The objective of this review was to assess the safety and effectiveness of conjunctival autograft (with or without adjunctive therapy) compared with amniotic membrane graft (with or without adjunctive therapy) for pterygium. We also planned to determine whether use of MMC yielded better surgical results and to assess the direct and indirect comparative costs of these procedures. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 10, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2015), EMBASE (January 1980 to November 2015), PubMed (1948 to November 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to November 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 21 November 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 23 November 2015. Selection criteria We included in this review randomized controlled trials that had compared conjunctival autograft surgery (with or without adjunctive therapy) with amniotic membrane graft surgery (with or without adjunctive therapy) in people with primary or recurrent pterygium. Data collection and analysis Two review authors independently screened search results and assessed full-text reports from among the potentially eligible trials. Two review authors independently extracted data from the included trials and assessed the trial characteristics and risk of bias. The primary outco...

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Section: Resultsmentioning

confidence: 99%

Conjunctival autograft for pterygium

Clearfield

Muthappan

Wang

et al. 2016

Cochrane Database of Systematic Reviews

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“…22 Steroids have been used in the eye to diminish excessive fibrosis after different corneal and conjunctival surgical procedures, such as photorefractive keratectomy, pterygium, and symblepharon. 16,23,24 Corticosteroids also contribute to the synthesis of a basement membrane, which is important for the regeneration of epithelial tissue. 21 Interestingly, in this study, animals that received a subconjunctival injection of corticosteroid showed less corneal stromal opacity compared with those that received saline.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15] Recently, our group reported good results with the use of subconjunctival steroid injections to prevent recurrence of pterygium in eyes that were submitted to excision combined with conjunctival autografting and/or amniotic membrane grafting. 16 The aim of this study was to evaluate the efficacy and safety of the therapeutic use of subconjunctival triamcinolone in an animal model of acute ocular alkali burn.…”

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confidence: 99%

Clinical and Histopathological Outcomes of Subconjunctival Triamcinolone Injection for the Treatment of Acute Ocular Alkali Burn in Rabbits

Saud

Moraes

Marculino

et al. 2012

Cornea

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“…A retomada da proliferação verificada 18 dias após a exposição nos fibroblastos de pterígios indica que a droga neces sita de exposições mais frequentes, provavelmente em intervalos entre 12 e 18 dias, para que seja mantido seu efeito antiproliferativo que foi inicialmente observado. Estudo envolvendo o acetonida de triancinolona aplicado por via subconjuntival em pterígios reci divados, mostrou serem necessárias de uma a três injeções, com uma média de 3,4 semanas entre elas (4) Estes achados clínicos corroboram com o presente estudo, realizado in vitro, que demonstrou que a triancinolona perdeu sua ação antiproliferativa, com volta da atividade fibroblástica na última avaliação (18 dias após a exposição).…”

Section: Discussionunclassified

Exposição de fibroblastos de pterígios recidivados e da cápsula de Tenon normal à triancinolona

Viveiros¹,

Kitakawa²,

Carvalho³

et al. 2012

Arq. Bras. Oftalmol.

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INTRODUÇÃOO receio da recidiva do pterígio após exérese, leva ao uso de medicações adjuvantes. A triancinolona é um corticosteroide potente, de depósito, que atua inibindo a síntese de prostaglandinas e leucotrienos, com consequente efeito anti-inflamatório. Utilizada há anos em vários campos da medicina, a triancinolona é um corticosteroide que vem sendo utilizado na Oftalmologia recentemente, no tratamento de inflamações intraoculares, edema macular associa do à pseudofacia, retinopatia diabética, oclusão de veia central da retina, vasculites retinianas e membrana neovascular sub-retiniana de várias etiologias. Efeitos adversos significativos, tais como, catarata, hipertensão ocular, descolamento de retina e endoftalmite, já foram relatados (1) .Porém, pouco ainda se sabe sobre o uso da triancinolona como medicamento adjuvante no tratamento do pterígio, o que motivou o presente estudo, realizado com o objetivo de avaliar a atividade pro liferativa dos fibroblastos da cápsula de Tenon, provenientes de explantes de pterígios recidivados, em cultura de células, comparando-os com a atividade proliferativa dos fibroblastos da cápsula de Tenon normal, quando expostos à triancinolona. MÉTODOS

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Postoperative Subconjunctival Corticosteroid Injection to Prevent Pterygium Recurrence

Abstract: The postoperative use of subconjunctival triamcinolone seems to benefit patients at increased risk of pterygium recurrence. It is relatively safe and is accompanied by few complications, but controlled and prospective studies are necessary to confirm its efficacy.

Cited by 31 publications

References 20 publications

Conjunctival autograft for pterygium

Conjunctival autograft for pterygium

Clinical and Histopathological Outcomes of Subconjunctival Triamcinolone Injection for the Treatment of Acute Ocular Alkali Burn in Rabbits

Exposição de fibroblastos de pterígios recidivados e da cápsula de Tenon normal à triancinolona

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