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1. Pterygium

Pterygium Pterygium - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Pterygium Last reviewed: February 2019 Last updated: January 2018 Summary A wing-shaped fibrovascular overgrowth from the conjunctiva onto the corneal surface. Occurs in the interpalpebral region, usually from nasal side, and is often bilateral. Consists of a cap (sub-epithelial arc-shaped corneal opacity at the leading edge), head (white fibrous (...) . If symptomatic, topical lubricants may help. Surgical intervention is indicated if significant ocular irritation persists despite medical therapy; or if there is impaired ocular cosmesis, reduced visual acuity, continued progression, or double vision. Surgical removal is generally successful, but some symptoms may persist and pterygium can recur. Definition eA pterygium (from the Greek pterygion , meaning wing) is a triangular-shaped fibrovascular overgrowth onto the corneal surface, continuous at its base

2018 BMJ Best Practice

2. Pterygium surgery combined with the removal of a missed occult iris foreign body detected incidentally during pterygium examination: a case report. (PubMed)

Pterygium surgery combined with the removal of a missed occult iris foreign body detected incidentally during pterygium examination: a case report. An occult foreign body may be retained in patient with small self-sealing wound and no decreased visual acuity without complete examination. Here we report a case of a retained occult ferrous iris foreign body detected incidentally during pterygium examination.A 69-year-old man presented to our ophthalmology department because of foreign body (...) sensation and persistent redness in both eyes for 2 years. In the left eye, a pterygium, paracentral corneal opacity and a vertically oval pupil were observed. Ultrasound biomicroscopy and gonioscopy revealed a retained metallic-like foreign body partially embedded in the inferior peripheral iris. Pterygium surgery and the removal of the retained iris foreign body were performed simultaneously. No recurrent pterygium or residual foreign body was found during follow-up.A thorough history should

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2019 BMC Ophthalmology

3. Pterygium

Pterygium Pterygium submit The College submit You're here: Pterygium Pterygium The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Fibrovascular growth progressing from the bulbar conjunctiva to involve the cornea Possibly a tissue response to irritants rather than a true degeneration The prevalence of pterygium varies from 1.2 (...) Epithelial iron deposit (Stocker’s line) ahead of advancing pterygium Relatively rich surface vascularisation Flattening of cornea in horizontal meridian Differential diagnosis Pinguecula (no corneal involvement) Pannus Pseudopterygium adhesion of a fold of conjunctiva to a peripheral corneal ulcer, which is fixed only at its apex to the cornea (pterygium is adherent to underlying structures throughout) Carcinoma in situ of the cornea or conjunctiva (also known as Bowen’s disease and as intraepithelial

2018 College of Optometrists

4. Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery. (PubMed)

Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery. Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods (...) by Cochrane. Our primary outcome was recurrence of pterygium defined as any re-growth of tissue from the area of excision across the limbus onto the cornea. The secondary outcomes were surgical time and complication rate. We graded the certainty of the evidence using GRADE.We included 14 RCTs conducted in Brazil, China, Egypt, India, Malaysia, New Zealand, Philippines, Saudi Arabia, Sweden and Turkey. The trials were published between 2004 and 2016, and were assessed as a mixture of unclear and low risk

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2016 Cochrane

5. Conjunctival autograft for pterygium. (PubMed)

Conjunctival autograft for pterygium. 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

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2016 Cochrane

6. Concomitant use of conjunctival tissue graft from the pterygium itself without rotation in pterygium surgery: A full circle in conjunctival autografting (PubMed)

Concomitant use of conjunctival tissue graft from the pterygium itself without rotation in pterygium surgery: A full circle in conjunctival autografting The aim of this study is to describe a modified technique of using conjunctival tissue from the pterygium itself without any rotation of graft for the primary pterygium in eyes with glaucoma filtering bleb, glaucoma suspects, and in primary double-head pterygium using fibrin glue.In this retrospective, noncomparative, interventional case series (...) , 98 eyes of 98 patients with primary pterygium operated between July 2011 to July 2016 were included. They underwent this technique from the pterygium tissue itself. There was no rotation of this graft, and it was adhered to the bare scleral defect with fibrin glue. Histopathological analysis of pterygium tissue was done to look for morphology and thickness of this thin conjunctival tissue obtained from pterygium tissue itself. The primary outcome measure was recurrence rate. Other outcome

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2018 Indian journal of ophthalmology

7. Clinical results for combination of fibrin glue and nasal margin suture fixation for attaching conjunctival autografts after pterygium excision in Chinese pterygium patients. (PubMed)

Clinical results for combination of fibrin glue and nasal margin suture fixation for attaching conjunctival autografts after pterygium excision in Chinese pterygium patients. This study was designed to compare postoperative complications and postoperative discomfort when using glue combined with nasal margin suture fixation versus fibrin glue or sutures alone to attach conjunctival autografts among Chinese patients during pterygium excisions.We analyzed the medical records of 150 eyes of 150 (...) patients with primary pterygium, in which the autografts were secured by 3 different methods after pterygium excision: 50 eyes were secured with fibrin glue, 50 eyes were secured with glue + nasal sutures, and 50 eyes were secured with sutures. The more than 6 months of follow-up observation data included postoperative complications (graft loss/displacement, dehiscence, proliferative granuloma, inflammation, and hemorrhage), recurrence, and postoperative discomfort. A logistic regression procedure

2018 Medicine

8. Simple limbal epithelial transplantation for recurrent pterygium: A case series (PubMed)

Simple limbal epithelial transplantation for recurrent pterygium: A case series Pterygium recurrence is a common complication of pterygium removal. Multiple surgical and medical approaches have been utilized to reduce recurrence rates. The present case series proposes a novel way to treat recurrent pterygia, by using the simple limbal epithelial transplantation (SLET) technique.The cases of four patients who presented with recurrent pterygium were reviewed. In all four of the cases reported (...) , the SLET procedure went without complication. There were no significant recurrences at each of the patient's most recent follow-up visits.This is the first report of SLET being used as a treatment modality for recurrent pterygium. Further studies are required to more reliably demonstrate the utility of the procedure in this clinical circumstance, but our results are encouraging that in select patients, this may be a viable option in treating aggressive recurrent pterygia.

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2018 American journal of ophthalmology case reports

9. Prevalence of pterygium in Iran: a systematic review and meta-analysis study. (PubMed)

Prevalence of pterygium in Iran: a systematic review and meta-analysis study. Pterygium is one of the most prevalent pathologies involving the cornea, which can lead to various vision signs and even reduction in eyesight. No accurate estimate has been reported about the prevalence of pterygium in Iran. Hence, this study aimed to determine the pterygium prevalence in Iran by meta-analysis method.Searching for data of the last eleven years (from 2004 to 2015) was conducted using the keywords (...) of pterygium, eye, and Iran in International and domestic indexing services and databases including Iranmedex, Scientific Information Database (SID), Magiran, Irandoc, Medlib, IranPsych, Science Direct, Web of Science (Thomson Reuters), PubMed, and Scopus. The data were analyzed using the meta-analysis method (the random effects model). The disharmony of the studies was investigated using the I2 index. The data were analyzed by STATA Ver.11 software.In 5 studies conducted in Iran, with a sample size

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2018 Electronic physician

10. Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial (PubMed)

Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence.to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation (...) autograft (CRA) and conjunctival autograft (CA), in treating pterygium.This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other

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2017 Electronic physician

11. Critical Role of mTORC2-Akt Signaling in TGF-β1-Induced Myofibroblast Differentiation of Human Pterygium Fibroblasts. (PubMed)

Critical Role of mTORC2-Akt Signaling in TGF-β1-Induced Myofibroblast Differentiation of Human Pterygium Fibroblasts. Profibrotic activation is essential for pterygium development. In this study, we investigated the role of the mechanistic target of rapamycin (mTOR) in regulating TGF-β1-induced myofibroblastic responses in human pterygium fibroblasts (HPFs) and elucidated the relative contributions of mTOR signaling components.HPFs were pretreated with the mTOR inhibitors rapamycin and Torin2 (...) inhibition potently reduced the contractile ability of HPFs in collagen gel contraction assays.This study found that mTOR signaling promoted profibrotic activation of HPFs and confirmed the importance of the mTORC2-Akt axis in TGF-β1-induced myofibroblast differentiation. Therefore, our study may open up new avenues for the development of novel therapeutic strategies involving targeting of mTOR signaling to treat pterygium.

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2019 Investigative Ophthalmology & Visual Science

12. Prevalence and risk factors for pterygium: a cross-sectional study in Han and Manchu ethnic populations in Hebei, China. (PubMed)

Prevalence and risk factors for pterygium: a cross-sectional study in Han and Manchu ethnic populations in Hebei, China. To investigate the prevalence, ethnic differences and associated risk factors for pterygium in Han and Manchu populations aged 40-79 years in Hebei province, China.Cross-sectional study, as a part of the China National Health Survey.Hebei province, China.A multistage cluster sampling method with urbanisation level-based stratification was used to select participants (...) for this study. A total of 4591 individuals over 40 years were recruited for this study. Inclusive criteria: (1) residents who had been living in Hebei for more than 1 year; (2) Han individuals with both parents being Han, or Manchu individuals with both parents being Manchu; (3) underwent ophthalmic examinations and (4) information in the questionnaire was complete.Multiple logistic regression analysis was used to evaluate the association between pterygium prevalence and factors of interest.A total of 3790

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2019 BMJ open

13. Pterygium Prevalence and Its Associations in a Russian Population: The Ural Eye and Medical Study. (PubMed)

Pterygium Prevalence and Its Associations in a Russian Population: The Ural Eye and Medical Study. To assess the prevalence of pterygia and its associations in a population of Russia.Population-based cross-sectional study METHODS: The Ural Eye and Medical Study was performed in a rural and urban area in Ufa/Bashkortostan 1300 km East of Moscow. Out of 7328 eligible individuals aged 40+ years, 5,899 (80.5%) individuals participated and underwent an ocular and systemic examination. Pterygia (...) defined as conjunctival extensions onto the clear cornea were diagnosed upon slit lamp examination and on corneal photographs.Mean pterygium prevalence (per individual) was 138/5888 (2.3%;95% confidence intervals (CI):2.0,2.7), with bilateral occurrence in 45 individuals (32.6% of patients with pterygium;0.8% of study population). Pterygium prevalence increased from 0.8% (95%CI:0.02,1.6) in the age group from 40-<45 years to 3.6% (95%CI:2.1,5.1) in the age group of 75+ years. In multivariable analysis

2019 American Journal of Ophthalmology

14. Metabolomics analysis in pterygium tissue. (PubMed)

Metabolomics analysis in pterygium tissue. The aim of the study was to measure amino acid levels with the metabolomics analysis in pterygium tissue and normal conjunctiva tissue.In this prospective, randomized, clinical study, a comparison of the amino acid profile of pterygium tissue and normal conjunctiva tissue taken during autograft pterygium surgery was made. After homogenization of the tissues, amino acid levels were measured with chromatography-mass spectrometry (LC-MS/MS (...) ) in the biochemistry laboratory. Statistical analysis was made using the Wilcoxon signed-rank test.Evaluation of pterygium and normal conjunctiva tissues of 29 patients, comprising 16 females and 13 males with a mean age of 54.75 ± 11.25 years (range 21-78 years) was made. While a dramatic increase was observed in all the amino acid levels in the pterygium tissue compared to the normal conjunctiva (p > 0.05), only the increases in arginine, methionine, glycine and tyrosine amino acids were determined

2019 International ophthalmology

15. Identification and correction of restrictive strabismus following pterygium excision surgery. (PubMed)

Identification and correction of restrictive strabismus following pterygium excision surgery. To report the characteristics of patients with restrictive diplopia following pterygium excision and a successful treatment approach for the strabismus.Retrospective interventional case series.Single academic institution.Fifteen patients with restrictive diplopia after pterygium excision.any other reason for strabismus.Patients were evaluated for deficits with special attention to diplopic measures (...) . The intervention was a combined procedure by a strabismologist and oculoplastic surgeon to correct the diplopia.Subjective and objective improvement of diplopia.Fifteen patients (mean age 49 years) who developed diplopia after pterygium excision were included. Mean time to diplopia was 6 months. All patients had limited abduction in the previously operated eye, causing esotropia in the abductive field (mean deviation 18 prism diopters). After intervention, all patients were no longer diplopic in primary gaze

2019 American Journal of Ophthalmology

16. Optical Coherence Tomography Angiography for Evaluation of Reperfusion following Pterygium Surgery. (PubMed)

Optical Coherence Tomography Angiography for Evaluation of Reperfusion following Pterygium Surgery. To describe the use of optical coherence tomography angiography (OCTA) to quantitatively monitor the conjunctival graft revascularization after pterygium excision and conjunctival autograft (CAG) transplantation.Prospective, interventional case series.Ten patients undergoing pterygium excision and femtosecond laser-assisted CAG transplantation were included. OCTA was performed at 1 week, 1 and 3

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2019 American Journal of Ophthalmology

17. Bromfenac Inhibits TGF-β1-Induced Fibrotic Effects in Human Pterygium and Conjunctival Fibroblasts. (PubMed)

Bromfenac Inhibits TGF-β1-Induced Fibrotic Effects in Human Pterygium and Conjunctival Fibroblasts. Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown antifibrotic effects on several diseases. The aims of the present in vitro study were to investigate the antifibrotic effects of bromfenac (a kind of NSAID) on primary human pterygium fibroblasts (HPFs) and primary human conjunctival fibroblasts (HConFs), as well as to explore the possible mechanisms of these effects.The cells used

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2019 Investigative Ophthalmology & Visual Science

18. Prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. (PubMed)

Prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. The aim of this study was to assess the prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia.A cross sectional design study was carried out in 390 participants in Gondar city from April 15 to May 7, 2016. Basic ophthalmic examination was performed using portable slit lamb, 3.5x magnifying loop with torch light and a pretested and structured (...) questionnaire was completed. The raw data has been entered into EPI INFO 3.5.1 and analyzed by SPPSS version 20. Descriptive statistics was summarized descriptive data. Logistic regression was used to summarize the predictors of pterygium. The variables with p-value less than 0.05 were considered as significant risks of pterygium.The prevalence of pterygium among study participants was 151(38.7% (95%CI; 33.8-43.8)). Among those who have pterygium, 149(98.7%) were developed pterygium on the nasal side and 15

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2017 PLoS ONE

19. The incidence and prevalence of pterygium in South Korea: A 10-year population-based Korean cohort study. (PubMed)

The incidence and prevalence of pterygium in South Korea: A 10-year population-based Korean cohort study. Although numerous population-based studies have reported the prevalences and risk factors for pterygium, information regarding the incidence of pterygium is scarce. This population-based cohort study aimed to evaluate the South Korean incidence and prevalence of pterygium. We retrospectively obtained data from a nationally representative sample of 1,116,364 South Koreans in the Korea (...) National Health Insurance Service National Sample Cohort (NHIS-NSC). The associated sociodemographic factors were evaluated using multivariable Cox regression analysis, and the hazard ratios and confidence intervals were calculated. Pterygium was defined based on the Korean Classification of Diseases code, and surgically removed pterygium was defined as cases that required surgical removal. We identified 21,465 pterygium cases and 8,338 surgically removed pterygium cases during the study period

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2017 PLoS ONE

20. Inhibition of Pterygium Fibroblast Migration and Outgrowth by Bevacizumab and Cyclosporine A Involves Down-Regulation of Matrix Metalloproteinases-3 and -13. (PubMed)

Inhibition of Pterygium Fibroblast Migration and Outgrowth by Bevacizumab and Cyclosporine A Involves Down-Regulation of Matrix Metalloproteinases-3 and -13. We examined the connection between matrix metalloproteinase (MMP) expression/activity and pterygium fibroblast migration, and how these were affected by bevacizumab and/or cyclosporine A (CsA). Fibroblasts were obtained from 20 pterygia and 6 normal conjunctival specimens. Expression levels of MMP-3 and MMP-13 were examined after (...) bevacizumab administration. Immunofluorescence staining was used to examine expression of both MMPs in fibroblasts migrating out from explanted pterygium tissues. Rates of cell migration from explant-cultured pterygia tissues and scratch-wounded confluent pterygium fibroblasts were examined in the presence of MMP-3 or MMP-13 inhibitors, as well as bevacizumab and/or CsA. A scratch wound healing migration assay was performed to determine the effects of bevacizumab and/or CsA. Protein expression of both

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2017 PLoS ONE

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