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Ophthalmology Apr 1994To define the amount of time necessary to follow patients after pterygium removal to identify a recurrence.
PURPOSE
To define the amount of time necessary to follow patients after pterygium removal to identify a recurrence.
METHODS
The authors reviewed patients who supposedly had a recurrence of their pterygium and analyzed the records to determine the duration of these recurrences.
RESULTS
One hundred sixty-one known pterygium recurrences were identified from records. Those patients with frequent follow-up in whom recurrence could be determined to within 1 month were in group A, and those in whom the time of recurrence was indefinite were in group B. For patients in group A, there was an average time to the first recurrence of 123 +/- 113 days, with second and third recurrences at 97 +/- 58 and 67 +/- 47 days, respectively. Survival curve analysis showed that there was a 50% chance that there would be a recurrence within the first 120 days, and there was a 97% chance there would be a recurrence within 12 months of its removal.
CONCLUSION
This suggests that a 1-year follow-up time is likely to identify a recurrence.
Topics: Adolescent; Adult; Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Probability; Pterygium; Recurrence; Time Factors
PubMed: 8152771
DOI: 10.1016/s0161-6420(94)31270-x -
Eye & Contact Lens Jan 2022To provide an updated review of surgical techniques and adjuvants for the management of pterygium.
OBJECTIVE
To provide an updated review of surgical techniques and adjuvants for the management of pterygium.
METHODS
A literature search was conducted in PubMed for studies published since January 2011. "Pterygium surgery" and the MeSH term "Pterygium/surgery" was used. The results were filtered for randomized controlled trials in English, yielding 60 citations.
RESULTS
One study compared topical anesthetic agents. One study compared methods of corneal polishing of the corneoscleral bed after pterygium excision. Numerous studies evaluated the use of conjunctival autograft versus amniotic membrane, superior versus inferior conjunctival autograft, and conjunctival versus limbal-conjunctival autograft. Many studies evaluated graft fixation methods. Several studies evaluated the adjuvant use of mitomycin C, 5-fluorouracil, and bevacizumab. A few studies evaluated the adjuvant use of steroids. Eleven studies evaluated various methods of postoperative management.
CONCLUSIONS
Current evidence supports pterygium excision with conjunctival autograft fixation using fibrin glue, followed by patching until the first postoperative visit. Surgical adjuvants and postoperative use of artificial tears and topical cyclosporine 0.05% may further reduce recurrence. Postoperative use of topical steroids is highly variable because there is no consensus regarding the optimal dose, frequency, and duration of treatment.
Topics: Humans; Pterygium
PubMed: 34686641
DOI: 10.1097/ICL.0000000000000849 -
Investigative Ophthalmology & Visual... Sep 2014To determine the association of cigarette smoking with pterygium. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To determine the association of cigarette smoking with pterygium.
METHODS
Potentially eligible studies published from the year 1946 to December 28, 2013 were identified from MEDLINE, EMBASE, and Cochrane Library databases, and reference lists. All studies that evaluated smoking as an independent factor for pterygium were identified. Study-specific odds ratios (ORs) were combined using the random-effects model when P < 0.1 in the test for heterogeneity, or otherwise the fixed-effects model was used. Meta-regression, sensitivity analysis, and evaluation of potential biases were undertaken. The ORs with 95% confidence intervals (CIs) of smoking as an associated factor for pterygium were analyzed.
RESULTS
We included 24 articles incorporating 95,279 participants from 20 cross-sectional studies, 2 hospital-based case-control studies, and 2 population-based cohort studies. The combined OR of cigarette smoking (current or ever smoked) for risk of pterygium was 0.82 (95% CI, 0.69-0.97; P = 0.025). The results remained consistent among current smokers (OR, 0.68; 95% CI, 0.61-0.76; P = 4.57 × 10(-12)), but not in ex-smokers (OR, 1.05; 95% CI, 0.87-1.27; P = 0.59). The impact of ultraviolet light (UV) exposure (P = 0.082) and sex (P = 0.553) on the effect of smoking was insignificant in meta-regression. Sensitivity analysis confirmed the protective effect and nonrelevance of these two study-level variables. Begg's funnel plots and Egger's test showed minimal publication bias.
CONCLUSIONS
The results of this meta-analysis show that cigarette smoking was associated with a reduced risk of pterygium, especially in current smokers. This effect may be independent of UV exposure and sex. Investigations are needed to unveil its molecular basis serving therapeutic purposes.
Topics: Global Health; Humans; Morbidity; Prognosis; Pterygium; Risk Assessment; Risk Factors; Smoking
PubMed: 25190665
DOI: 10.1167/iovs.14-15046 -
American Journal of Medical Genetics 1980We describe a sporadic case and four sibs from a consanguineous Nicaraguan family affected with the multiple pterygium syndrome. Clinical manifestations included normal...
We describe a sporadic case and four sibs from a consanguineous Nicaraguan family affected with the multiple pterygium syndrome. Clinical manifestations included normal intelligence; short stature; pterygia of neck, axillary, antecubital, popliteal, digital, and intercrural areas; multiple joint contractures with a crouched stance; a flat, sad, motionless facial appearance; and cleft palate. Males had small penis and scrotum and cryptorchidism; females had apparent aplasia of labia majora and small clitoris. Skeletal anomalies included fusion of cervical vertebrae, scoliosis, flexion contractures of fingers and "rocker-bottom" feet with vertical talus. This review documents genetic heterogeneity: Autosomal recessive inheritance in many cases, autosomal dominant determination in others, and sporadic occurrence.
Topics: Abnormalities, Multiple; Child; Consanguinity; Diagnosis, Differential; Female; Humans; Infant, Newborn; Male; Pedigree; Pterygium
PubMed: 7468651
DOI: 10.1002/ajmg.1320070203 -
Southern Medical Journal Feb 1953
Topics: Humans; Pterygium; Radiotherapy
PubMed: 13038518
DOI: 10.1097/00007611-195302000-00005 -
Arquivos Brasileiros de Oftalmologia 2022
Topics: Humans; Pterygium; Dry Eye Syndromes; Conjunctiva; Risk Factors
PubMed: 36350930
DOI: 10.5935/0004-2749.2022-0240 -
American Journal of Ophthalmology Nov 1972
Topics: Adolescent; Adult; Age Factors; Aged; Arabia; Ethnicity; Female; Humans; Israel; Male; Middle Aged; Occupations; Pterygium; Seasons; Sex Factors
PubMed: 4644742
DOI: 10.1016/0002-9394(72)91217-2 -
Scientific Reports Jan 2022Pterygium is a common ocular surface condition frequently associated with irritative symptoms. The precise identity of its critical triggers as well as the hierarchical... (Meta-Analysis)
Meta-Analysis
Pterygium is a common ocular surface condition frequently associated with irritative symptoms. The precise identity of its critical triggers as well as the hierarchical relationship between all the elements involved in the pathogenesis of this disease are not yet elucidated. Meta-analysis of gene expression studies represents a novel strategy capable of identifying key pathogenic mediators and therapeutic targets in complex diseases. Samples from nine patients were collected during surgery after photo documentation and clinical characterization of pterygia. Gene expression experiments were performed using Human Clariom D Assay gene chip. Differential gene expression analysis between active and atrophic pterygia was performed using limma package after adjusting variables by age. In addition, a meta-analysis was performed including recent gene expression studies available at the Gene Expression Omnibus public repository. Two databases including samples from adults with pterygium and controls fulfilled our inclusion criteria. Meta-analysis was performed using the Rank Production algorithm of the RankProd package. Gene set analysis was performed using ClueGO and the transcription factor regulatory network prediction was performed using appropriate bioinformatics tools. Finally, miRNA-mRNA regulatory network was reconstructed using up-regulated genes identified in the gene set analysis from the meta-analysis and their interacting miRNAs from the Brazilian cohort expression data. The meta-analysis identified 154 up-regulated and 58 down-regulated genes. A gene set analysis with the top up-regulated genes evidenced an overrepresentation of pathways associated with remodeling of extracellular matrix. Other pathways represented in the network included formation of cornified envelopes and unsaturated fatty acid metabolic processes. The miRNA-mRNA target prediction network, also reconstructed based on the set of up-regulated genes presented in the gene ontology and biological pathways network, showed that 17 target genes were negatively correlated with their interacting miRNAs from the Brazilian cohort expression data. Once again, the main identified cluster involved extracellular matrix remodeling mechanisms, while the second cluster involved formation of cornified envelope, establishment of skin barrier and unsaturated fatty acid metabolic process. Differential expression comparing active pterygium with atrophic pterygium using data generated from the Brazilian cohort identified differentially expressed genes between the two forms of presentation of this condition. Our results reveal differentially expressed genes not only in pterygium, but also in active pterygium when compared to the atrophic ones. New insights in relation to pterygium's pathophysiology are suggested.
Topics: Adult; Aged; Databases, Genetic; Female; Gene Expression Profiling; Gene Expression Regulation; Gene Regulatory Networks; Humans; Male; MicroRNAs; Middle Aged; Oligonucleotide Array Sequence Analysis; Pterygium; RNA, Messenger; Transcriptome
PubMed: 34997134
DOI: 10.1038/s41598-021-04248-x -
International Journal of Molecular... Apr 2009Pterygium is a fibrovascular lesion of the ocular surface that can display an aggressive clinical behavior and, occasionally, threaten vision. Although there is no... (Review)
Review
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.
Topics: Humans; Mutation; Pterygium; Tumor Suppressor Protein p53; ras Proteins
PubMed: 19288018
DOI: 10.3892/ijmm_00000149 -
Indian Journal of Ophthalmology 2007To study the effect of pterygium on corneal topography, a retrospective analysis of 151 eyes with primary pterygia was done. All cases underwent videokeratography...
To study the effect of pterygium on corneal topography, a retrospective analysis of 151 eyes with primary pterygia was done. All cases underwent videokeratography preoperatively and one month postoperatively. Statistical analysis of average corneal power (ACP), corneal astigmatism, surface regularity index (SRI) and surface asymmetry index (SAI) was done before and one month after surgery. Topographic indices were compared statistically for various grades of pterygia. Increase in the grade of pterygia had a significant effect on topographic indices. Corneal astigmatism reduced from 4.40+/-3.64 diopter (D) to 1.55+/-1.63D ( P value < 0.001) following surgery. The regularity of corneal surface improved and asymmetry of the cornea reduced one month after surgery. Pterygium leads to significant changes in corneal refractive status, which increase with the increase in the grade of pterygia and improve following pterygium excision.
Topics: Astigmatism; Conjunctiva; Cornea; Corneal Topography; Follow-Up Studies; Humans; Ophthalmologic Surgical Procedures; Pterygium; Refraction, Ocular; Retrospective Studies; Severity of Illness Index
PubMed: 17699952
DOI: 10.4103/0301-4738.33829