Objective: This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. Methods: This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft. Results: We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00). Conclusion There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.
Pterygium Of Conjunctiva And Cornea ; Pterygium ; Mitomycin ; Autografts ; Conjunctiva ; Conjunctivitis ; Transplantation, Autologous

Granuloma pyogenicum is an acutely and chronically inflamed granulation tissue protruded on conjunctiva, cornea, limbus and lid, which results from surgical trauma, foreign body, microbial infection or parasite as well as spontaneous occurrence. It rapidly enlarges forming painless polypoid mass, and consists of many inflammatory cells and characteristically well-developed capillaries. It can be frequently misinterpreted as squamous cell carcinoma or other tumor. Treatment is radical excision and electric fulguration followed by suture. The authors experenced a case of granuloma pyogenicum occurred after removal of pterygium.
Capillaries ; Carcinoma, Squamous Cell ; Conjunctiva* ; Cornea ; Foreign Bodies ; Granulation Tissue ; Granuloma* ; Granuloma, Pyogenic* ; Parasites ; Pterygium* ; Sutures

The author suppose the etiology of the pterygium as combination of following various factors. 1) Irritation of the sun light, wind and dust. 2) Pterygium is frequently encroachment of a pinguecula onto the cornea. 3) Continuous movement of the eye may influence upon the formation of the pterygium. 4) Constiant rubbing of the semilunar fold against bulbar conjunctiva of the internal palpebral fissure. 5) Conjunctival fold due to resistance of the caruncle in ocular movement cause the pressure to the medial limbus. This fact may largely influence upon the formation of the pterygium. 6) Frequent mechanical irritation to the internal palpebal fissure in washing one's face and other daily works. 7) Accumulation of the tear film and dusts on the inner canthal region constantly irritate bulbar conjunctiva. 8) Subconjunctival connective tissue and subconjunctival hypertrophied tissue (a kind of subconjunctival pathologic connective tissue) near the caruncle play great role of the formation and recurrent of the pterygium. This hypothesis based on the fact that extensive and large amount of removal of the subconjunctival pathologic connective tissue according to the author's new operation method revealed complete prevention of the recurrence of pterygium. 9) Incidence of the pterygium on the medial side is over 98% in spite of same condition of the lateral and medial conjunctiva. The author suppose this fact is due to above prescripted various factors.
Conjunctiva ; Connective Tissue ; Cornea ; Dust ; Incidence ; Pinguecula ; Pterygium* ; Recurrence ; Solar System ; Tears ; Wind

PURPOSE: To evaluate the effectiveness of Mitomycin C used as a combined therapy along with limbal-conjunctival autograft for primary pterygium. METHODS: Thirty eyes of 29 patients received Mitomycin C (0.02% MMC 3 minutes) with limbal-conjunctival autograft, and 30 eyes of 28 patients received limbal-conjunctival autograft alone. Recurrence and complications were evaluated in the patients at 2 weeks, 1, 3, 6 and 12 months postoperatively. RESULTS: Mean follow-up periods were 13.4+/-2.1 and 13.9+/-2.9 months, respectively. Between the two groups, recurrence in the conjunctiva or the cornea was not observed during the follow-up period. In the Mitomycin C use group, complications included a granuloma at the donor site (1 eye, 3.3%), wound dehiscence (2 eyes, 6.7%), and subgraft hemorrhage (2 eyes, 6.7%). In comparison, in the group treated with limbal-conjunctival autograft alone, complications included granuloma at the donor site (1 eye, 3.3%), pseudopterygium at the donor site (1 eye, 3.3%), wound dehiscence (3 eyes, 10%), and subgraft hemorrhage (2 eyes, 6.7%). CONCLUSIONS: The use of Mitomycin C as an adjuvant therapy has no significant effect on the recurrence rate in primary pterygium with limbal-conjunctival autograft.
Conjunctiva ; Cornea ; Eye ; Follow-Up Studies ; Granuloma ; Hemorrhage ; Humans ; Mitomycin ; Pterygium ; Recurrence ; Tissue Donors

Pterygium, a disease of unknown origin and pathogennesis, is a chronic condition characterized by the encroachment of triangular portion of the bulbar conjunctiva onto the cornea. We have studied the expression of extracellular matrix genes and oncogenes in cultured pterygium using Northernm dot, and slot blot hybridizations. Northern hybridization with total RNA isolated from passaged (4-8 passages) cultures demonstrated expression of genes for alpha1(I) and alpha1(III) procollagen, fibronectin, and c-Ha-ras, but no expression of gene for c-myc was observed. The pterygium exhibited significantly increased expression of alpha1(I) and alphal(III) procollagen genes when compared with normal control cells(p<0.01). And We observed there were no differences between pterygium and normal control cells in the expression of genes for fibronectin and c-Ha-ras. According to these results we thought that the causes of pterygium may be related to the increased expression of alpha1(I) and alphal(III) procollagen genes but may not be related to c-Ha-ras, c-myc, and fibronectin genes.
Conjunctiva ; Cornea ; Extracellular Matrix* ; Fibroblasts* ; Fibronectins ; Genes, myc* ; Oncogenes ; Procollagen ; Pterygium ; RNA

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.
Conjunctiva* ; Cornea ; Epithelium, Corneal ; Mitomycin ; Ophthalmic Solutions ; Pterygium ; Rabbits* ; Re-Epithelialization* ; Recurrence ; Sclera

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.
Conjunctiva* ; Cornea ; Epithelium, Corneal ; Mitomycin ; Ophthalmic Solutions ; Pterygium ; Rabbits* ; Re-Epithelialization* ; Recurrence ; Sclera

1. Apparent ocular findings obtained from a survey on 213 workers exposed to radiant energy were chronic hyperemic pigmented blepharoconjunctivitis (36.3%) which was supposed as a chronic abiotic and thermal lesion of photophthalmia, and pigmentation (melanosis) of bulbar conjunctiva near the limbus (11.5%). 2. Pterygium also was observed with high percentage (26.9%) and external irritative exposures ineluding ultra-violet rays were supposed to play a causative role in producing it. 3. Conjunctival and corneal foreign bodies (87.4%) were the most frequently observed among workers, due probably to improper protective eye equipment. 4. Everyone case of leucoma cornea traumatica, Ieucoma adherens traumatica, burned scar of the lid skin, healed scar of macular burn, macular hole after contusion and post-enucleated anophthalmos after rupture of eye ball was observed. 5. None of cataract case in early stage could be found because the slit-lamp biomicroscope was not available in this screening examination. 6. By ophthalmoscopy, 19 cases of hypertensive retinopathies were observed. 7. Comparison this result with author's former result obtained in 1966 also was made. 8. It is advisable to wear standard protective eye equipment and to administer health education to these workers.
Anophthalmos ; Burns ; Cataract ; Cicatrix ; Conjunctiva ; Contusions ; Cornea ; Foreign Bodies ; Health Education ; Hypertensive Retinopathy ; Mass Screening ; Ophthalmoscopy ; Pigmentation ; Pterygium ; Retinal Perforations ; Rupture ; Skin ; Ultraviolet Rays ; Welding*

PURPOSE: To evaluate the success and complication rates of triple procedure, including pterygium excision, marginal amniotic membrane insertion beneath the conjunctiva, and limbal-conjunctival autograft in pterygium surgery. METHODS: We conducted a retrospective study on 45 eyes of 45 patients who underwent pterygium surgery between August 2011 and October 2012. After pterygium excision, amniotic membrane was placed beneath the conjunctiva along the margin of the exposed sclera followed by a limbal conjunctival autograft. Success rates, intraoperative and postoperative complications were evaluated. RESULTS: Forty-three eyes with primary pterygium and 2 eyes with recurrent pterygium were enrolled in the present study. The mean age of the patients was 59.87 +/- 14.30 years with a mean follow-up of 12.9 +/- 4.6 months. There were no complications during surgery. Early postoperative complications included partial wound dehiscence in 1 eye and a simple conjunctival cyst on the autografted conjunctiva in the another eye. No clinically significant recurrence (G2, G3) was noted during the observational periods. Thirty-nine (86.7%) and 6 (13.3%) eyes were graded as G0 and G1, respectively. CONCLUSIONS: Our surgical technique not only has the benefits of the limbal conjunctival autograft acting as a barrier against fibrovascular invasion of the cornea and supplying stem cells to the corneal epithelium but also has antiangiogenic effects of amniotic membrane with minimal use. In addition, this technique is a safe surgical method in primary and recurrent pterygium.
Amnion ; Autografts ; Conjunctiva ; Cornea ; Epithelium, Corneal ; Follow-Up Studies ; Humans ; Postoperative Complications ; Pterygium* ; Recurrence ; Retrospective Studies ; Sclera ; Stem Cells ; Wounds and Injuries