Mistakes in the treatment of pterygium
G. I. Drozhzhina, Dr Sc (Med), Prof.; L.F. Troichenko, Cand Sc (Med); V.L. Ostashevskii, Cand Sc (Med); B.M. Kogan, Cand Sc (Med); T.B. Gaidamaka, Dr Sc (Med); E.V. Ivanovskaia, Cand Sc (Med)
SI " The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine”; Odesa (Ukraine)
TO CITE THIS ARTICLE: Drozhzhina G I, Troichenko LF, Ostashevskii VL, Kogan BM, Gaidamaka TB, Ivanovskaia EV. Mistakes in the treatment of pterygium. J.ophthalmol.(Ukraine).2019;4:18-22. http://doi.org/10.31288/oftalmolzh2019418222
Abrupt thinning and even perforation at the limbus and cornea due to deep pterygium excision are potential postoperative complications of pterygium syrgery. Postoperative complications were observed in 25.7% of patients after primary pterygium excision. The analysis of mistakes made in the surgical treatment of pterygium enabled the following recommendations to be made. First, pterygium should be excised with minimal trauma to the limbus and cornea. Second, the patient should be promptly referred to the medical facility at which he/she can undergo keratoplasty if complications (perforations and/or ulcers) develop during pterygium excision. Third, a patient’s concomitant autoimmune disease should be taken into account. Fourth, one should not perform bilateral pterygium surgery or repeat pterygium excision early (≤ 6 months) after primary pterygium surgery. Finally, steroid and antimetabolic therapy, barrier and optic lamellar keratoplasty, and amniotic membrane transplantation should be used to prevent pterygium recurrence.
Keywords: pterygium, treatment, mistakes
1.Isyaku M. Treatment of pterygium. Annals African Medicine. 2011;10(3):197-203.
2.Aliyev A-G. [Features of corneal aberrations in pterygium]. [Cand Sc (Med) Thesis]. Moscow: Research Institute for Eye Diseases; 2008. 117 p. Russian.
3.Bilalov EN. [Changes in biochemical characteristics of the tear fluid as a factor of the pathogenesis of pterygium]. Klinicheskaiia oftalmologiia. 2005;6(3):123-5. Russian.
4.Bilalov EN, Bakhritdinova FA. [Local microcirculation in persons with primary pterygium, as evidenced by fluorescein-angiographic studies]. Vestn Oftalmol. 2005 Nov-Dec;121(6):14-7. Russian.
5.Makeeva GA. [Tear production and pterygium]. Zdravookhraneniie Kazakhstana. 1981;6(423):27-9. Russian.
6.Bakbardina LM, Bakbardina II. [Peripheral barrier keratoplasty with biologically protected tissue bed in treatment of recurrent pterygium]. Oftalmol Zh. 2004;5:83-5. Russian.
7.Veselovs’ka NM, Lovtsova OD. [Method of microsurgical treating for pterygium]. Visnyk Vinnytskogo NMU. 2006;10(2):379. Ukrainian.
8.Erlyshev PA. [Operative treatment of pterygium with mobilization of the healthy conjunctiva]. Vestn Oftalmol. 1972;6:76-7. Russian.
9.Usov Via, Maltsev EV, Kritsun NIu. [Clinical efficacy of pterygium surgery technique involving use of high frequency welding of biological tissues for fixing free limbal conjunctival autograft]. Oftalmol Zh. 2015;6:6-12. Ukrainian.
10.Wit DD, Athanasiadis I, Sharma A, Moore J. Sutureless and glue-free conjunctival autograft in pterygium surgery: a case series. Eye. 2010;24:1474–7.
11.Borodin IuI, Val’skii VV, Verigo EN. [Late outcomes of combination treatment of recurrent pterygium]. Oftalmologiia. 2007;3(4):29-33. Russian.
12.Korets K. [Treatment of recurrent pterygium]. Vestn Oftalmol. 1970 Jan-Feb;1:84-5. Russian.
13.Bandyopadhyay R, Nag D, Mondal SK, Gangopadhyay S, Bagchi K, Bhaduri G. Ocular surface disorder in pterygium: Role of conjunctival impression cytology. Indian J Pathol Microbiol. 2010 Oct-Dec;53(4):692-5.
14.Fallah MR, Golabdar MR, Amozadeh J, et al. Transplantation of conjunctival limbal autograft and amniotic membrane vs. mitomycin C and amniotic membrane in treatment of recurrent pterygium. Eye. 2008 Mar;22(3):420-4.
15.Ye J, Kook KH, Yao K. Temporary amniotic membrane patch for the treatment of primary pterygium: mechanism of reducing the recurrence rate. Graefe’s Arch Clin Exp Ophthalmology. 2006 May;244(5):583-8.
16.Dzunic B, Jovanovich P, Vaselinovic D. Analysis of pathophysiological characteristics of pterygium. Bosnian J Basic Medical Sciences. 2010;10(4):307-13.
17.Buchko OIa, Tsyganova TA, Shishkin MM. [Analysis of early and late postoperative complications after pterygium excision by the technique of McReynolds]. In: Proceedings of the conference marking the 110th anniversary of the Moscow Helmholtz Research Institute for Eye Diseases. 7-8 October, 2010. Moscow, p.35-8. Russian.
18.Belyi IuA, Tereshchenko AV, et al. [A method for treating pterygium]. Novoiie v oftalmologii. 2008;(2):59. Russian.
The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.