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      Changes of Tear Film Function after Pterygium Operation

      research-article
      a, b , , a , a
      Ophthalmic Research
      S. Karger AG
      Pterygium, Tear film function, Pterygium operation

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          Abstract

          Objective: To assess changes of tear film function in patients with pterygium after pterygium excision combined with limbal-conjunctival autograft transplantation. Methods: Sixty eyes of 60 patients were entered in the study. The Schirmer test, tear breakup time (BUT) and mucus fern test (MFT) were evaluated in the patients before and after pterygium excision combined with limbal-conjunctival autograft transplantation. Results: Compared with the opposite healthy eyes, the BUT and MFT in the eyes with pterygium were significantly different before the operation (p < 0.05); however, there was no significant difference in the results of the Schirmer test (p > 0.05). The results of the BUT and MFT in the eyes with pterygium were significantly different before and 4 weeks after the operation (p < 0.05). The BUT was prolonged from 9.89 ± 3.95 to 12.78 ± 4.12 s, and the ratio of normal crystallization in the MFT increased from 46.7 to 80.0%. There was no significant difference in the Schirmer test results before and after the operation (p > 0.05). Conclusion: Tear functions were abnormal in the eyes with pterygium. Pterygium excision combined with limbal-conjunctival autograft transplantation can partially restore the tear film function into normal state, and the tear film function was stable 4 weeks after surgery.

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          Most cited references13

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          Pterygium as an early indicator of ultraviolet insolation: a hypothesis.

          M Coroneo (1993)
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            Long-term follow-up study of mitomycin eye drops as adjunctive treatment of pterygia and its comparison with conjunctival autograft transplantation.

            We observed 48 patients for 7-21 months (mean, 18 months) after pterygium excision and 2 weeks of placebo or mitomycin topical therapy to evaluate whether or not the short-term efficacy of mitomycin in preventing pterygium recurrence would be reflected in long-lasting efficacy as well. Placebo-treated pterygia showed a 73% recurrence rate. One of 58 (1.7%) mitomycin-treated pterygia recurred (p less than 0.05). We also performed a pilot study comparing pterygia treated with excision followed by 0.4 mg/ml of mitomycin to pterygia treated with excision coupled with conjunctival autograft transplantation to estimate the number of patients required for a randomized clinical trial comparing these two treatment modalities and thereby to decide whether or not such a study would be justified. Thirteen primary and two recurrent pterygia were treated with mitomycin, while 14 primary and one recurrent pterygia were treated with conjunctival autograft transplantation. With mean follow-up times of 4 and 6 months, respectively, no recurrences were noted in the mitomycin-treated group, while the conjunctival autograft transplantation group had one recurrence (6.6%). We estimate that 400 patients would be required for a properly designed clinical trial comparing these two effective therapies for prevention of recurrent pterygia. We conclude that such a study is unjustified, and further conclude that the vastly less expensive, simple therapy of mitomycin eye drops is the more appropriate treatment.
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              A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap.

              To compare the recurrence rate following treatment of recurrent pterygia using one of two techniques-limbal conjunctival autograft transplantation versus low-dose intraoperative mitomycin C (0.2 mg/ml) combined with conjunctival flap closure. Randomized clinical trial. Eighty-one patients with recurrent pterygia treated by limbal conjunctival autograft transplantation (n= 41) or mitomycin C combined with conjunctival flap (n= 40) participated. Limbal conjunctival autograft transplantation or low-dose intraoperative mitomycin C application with conjunctival flap technique was performed on recurrent pterygium cases. Recurrence of pterygium and postoperative complications. During mean follow-up periods of 16+/-1.9 and 15.5+/-1.5 months, six recurrences (14.6%) in the limbal conjunctival autograft transplantation group and five recurrences (12.5%) in the mitomycin C group were observed (P=0.77). The difference between the mean ages of recurrent (26.4+/-8.0 years) and nonrecurrent (35.8+/-11.9 years) cases for all patients was statistically significant (P=0.014). Technically, limbal conjunctival autograft transplantation seemed to be more difficult. The most frequent complication in limbal conjunctival autograft transplantation was graft edema, whereas that in the mitomycin C group was superficial keratitis. Both techniques showed similar recurrence rates in the treatment of recurrent pterygia. Although technically easier to perform, further follow-up is necessary to determine the long-term safety of low-dose intraoperative mitomycin C with conjunctival flap closure. The surgeon's familiarity with either procedure should determine the method of choice.
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                Author and article information

                Journal
                ORE
                Ophthalmic Res
                10.1159/issn.0030-3747
                Ophthalmic Research
                S. Karger AG
                0030-3747
                1423-0259
                2011
                April 2011
                17 November 2010
                : 45
                : 4
                : 210-215
                Affiliations
                aDepartment of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, and bDepartment of Ophthalmology, Taizhou Central Hospital, Taizhou, China
                Author notes
                *Yangshun Gu, Department of Ophthalmology, The First Affiliated Hospital, College of Medicine Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China), Tel. +86 571 8723 6393, E-Mail guyangshun_1@hotmail.com
                Article
                321531 Ophthalmic Res 2011;45:210–215
                10.1159/000321531
                21088440
                df8fc867-33e4-40f9-87da-76a3838d44c2
                © 2010 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 22 April 2010
                : 22 September 2010
                Page count
                Figures: 1, Tables: 2, References: 25, Pages: 6
                Categories
                Original Paper

                Vision sciences,Ophthalmology & Optometry,Pathology
                Pterygium operation,Pterygium,Tear film function

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