The Experts below are selected from a list of 12237 Experts worldwide ranked by ideXlab platform
Lawrence W Hirst - One of the best experts on this subject based on the ideXlab platform.
-
recurrence and complications after 1000 surgeries using Pterygium extended removal followed by extended conjunctival transplant
Ophthalmology, 2012Co-Authors: Lawrence W HirstAbstract:Objective To document the recurrence rate and complication rate of Pterygium extended removal followed by extended conjunctival transplant. Design An open, prospective study of consecutive Pterygium patients undergoing Pterygium extended removal followed by extended conjunctival transplant. Participants and Controls The study included 1000 consecutive patients undergoing Pterygium surgery between August 2001 and September 2009. Interventions All patients underwent Pterygium extended removal followed by extended conjunctival transplant by the author with attempted follow-up for 1 year. Main Outcome Measures Recurrence and complication rates. Results Follow-up of >1 year was obtained in 99% of patients. There was 1 recurrence in the 1000 surgeries (0.1%) with 95% confidence intervals of 0.003%–0.56% (Fischer exact test). Seven patients required further surgery: 3 had graft replacements, and 1 each for recurrence, strabismus, inclusion cyst, and granuloma. One patient lost 4 lines of vision from a corneal ulcer. Conclusions Pterygium extended removal followed by extended conjunctival transplant results in one of the lowest recurrence rates reported in the world's literature and an acceptable complication rate. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
-
recurrent Pterygium surgery using Pterygium extended removal followed by extended conjunctival transplant recurrence rate and cosmesis
Ophthalmology, 2009Co-Authors: Lawrence W HirstAbstract:Objective: To assess the rate of recurrence, complications, and cosmesis after recurrent Pterygium removal with P.E.R.F.E.C.T. for Pterygium (Pterygium Extended Removal Followed by Extended Conjunctival Transplant). Design: A case series study of P.E.R.F.E.C.T. for Pterygium was conducted by 1 surgeon with a 1-year follow-up to assess the recurrence, complication rate, and cosmesis. Participants: A total of 111 consecutive patients with recurrent Pterygium removals. Intervention: A major modification of conjunctival autograft surgery was used to treat recurrent pterygia. Main Outcome Measures: The recurrence rate, complications, and cosmesis after excision of recurrent pterygia using P.E.R.F.E.C.T. for Pterygium. Results: There were no patients with recurrence in 111 consecutive patients, and all but 2 patients were followed for at least 1 year. One patient developed an exotropia that required no treatment, and 1 patient lost 4 lines of vision as a result of a corneal ulcer. Conclusions: In this series, P.E.R.F.E.C.T. for Pterygium resulted in a zero recurrence rate (2 patients lost to follow-up) with few complications and a good cosmetic appearance. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
-
Pterygium and associated ocular surface squamous neoplasia
Archives of Ophthalmology, 2009Co-Authors: Lawrence W Hirst, Roy A Axelsen, Ivan R SchwabAbstract:OBJECTIVE: To measure the rate of histopathologically identified ocular surface squamous neoplasia (OSSN) in Pterygium specimens. METHODS: All Pterygium specimens collected from consecutive patients between April 8, 2003, and February 6, 2008, were submitted for histopathologic examination, and the rate of OSSN was calculated. RESULTS: The rate of OSSN was 9.8% (52 of 533) insequential Pterygium specimens. CONCLUSIONS: This rate of unsuspected OSSN suggests that all specimens of Pterygium should be submitted for histopathologic examination and that patients in whom OSSN is noted should be examined at more frequent intervals so any clinical OSSN that develops can be identified at an early stage.
-
prospective study of primary Pterygium surgery using Pterygium extended removal followed by extended conjunctival transplantation
Ophthalmology, 2008Co-Authors: Lawrence W HirstAbstract:Objective To assess the rate of recurrence and complications after primary Pterygium removal with the P.E.R.F.E.C.T. for Pterygium (Pterygium extended removal followed by extended conjunctival transplantation) technique. Design A case series study of the P.E.R.F.E.C.T. for Pterygium technique was conducted by 1 surgeon with a 1-year follow-up to assess the recurrence and complication rate. Participants Two hundred fifty consecutive primary Pterygium removals. Intervention A major modification of conjunctival autograft surgery was used to treat primary pterygia. Main Outcome Measures The recurrence rate and complications after excision of primary pterygia using the P.E.R.F.E.C.T. for Pterygium technique. Results One patient had a vascularized delle listed as a recurrence from among 250 consecutive patients (0.4%). The mean study follow-up period was 462±172 days. No patient lost best-corrected vision. Conclusions The P.E.R.F.E.C.T. for Pterygium technique results in a near 0% recurrence rate with minimal complications and a good cosmetic appearance.
Noha Rabie Bayomy - One of the best experts on this subject based on the ideXlab platform.
-
Role of oxidative stress and vascular endothelial growth factor expression in Pterygium pathogenesis and prevention of Pterygium recurrence after surgical excision
International Ophthalmology, 2020Co-Authors: Sameh Mohamed Elgouhary, Hesham Fouad Elmazar, Mariana Ibrahim Naguib, Noha Rabie BayomyAbstract:Purpose To assess the roles of oxidative stress and vascular endothelial growth factor (VEGF) in Pterygium pathogenesis and prevention of Pterygium recurrence after surgical excision. Methods Surgically removed Pterygium tissue from 35 Pterygium patients and normal conjunctival samples from 15 patients matched for age and sex (used as controls) constituted the study samples. The conjunctival samples were preserved at − 80 °C until analysis. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH) and total antioxidant (TAO) enzymatic activity and the levels of nitric oxide (NO), malondialdehyde (MDA) and VEGF were studied in both groups. To evaluate the recurrence rate after surgical excision, the Pterygium patients were further subdivided into three groups according to the adjuvant therapy used to prevent recurrence. Group 1 consisted of 10 patients who were treated with 0.2 mg mitomycin-c (MMC) for 2 min. Group 2 consisted of 12 patients treated with subconjunctival bevacizumab injection after surgical removal of the Pterygium. Group 3 consisted of 13 patients who underwent combined treatment with 0.2 mg of MMC for 2 min and subconjunctival bevacizumab injection. The follow-up of patients in the three groups ranged from 7 to 15 months. Results The activities of CAT, SOD, GSH and TAO were significantly lower in Pterygium samples than in normal conjunctival samples ( p
Alana Slomovic - One of the best experts on this subject based on the ideXlab platform.
-
the effect of mitomycin c on corneal endothelium in Pterygium surgery
American Journal of Ophthalmology, 2009Co-Authors: Irit Bahar, Igor Kaiserman, Alex P Lange, Alana Slomovic, Eliya Levinger, Wiwan SansanayudhAbstract:Purpose To evaluate the changes in endothelial cell counts in patients after Pterygium surgery with mitomycin C (MMC) 0.02% and to compare them with patients undergoing Pterygium excision without MMC. Design Prospective nonrandomized study. Methods Forty-three consecutive patients were included in this study. Sixteen patients underwent Pterygium surgery with conjunctival autograft and MMC for recurrent Pterygium and 27 patients underwent Pterygium excision without MMC for primary Pterygium removal (control group) at the Toronto Western Hospital. Endothelial images were acquired at the center of the cornea with a specular microscope before surgery and at one week, one month, and three months following surgery. Results Mean preoperative endothelial cell counts were 2330 ± 318 cells/mm 2 in the Pterygium excision without MMC group and 2486 ± 327 cells/mm 2 in the Pterygium excision with MMC group ( P = .13). One month after surgery, the Pterygium with MMC group showed a significant endothelial cell loss of 6% which was not present in the control group ( P = .03). Three months after surgery, endothelial cell loss was reduced to 4%. ( P = .08 compared with the control). In the Pterygium excision with MMC group, endothelial polymeghatism was increased (at one and three months) and the percentage of hexagomal cells was reduced (at one month). Conclusions The use of topical MMC during recurrent Pterygium surgery was found to have a deleterious effect on corneal endothelium one month following surgery. Judicious use of this drug is therefore recommended.
Dov Weinberger - One of the best experts on this subject based on the ideXlab platform.
-
Pterygium-induced corneal astigmatism.
Israel Medical Association Journal, 2020Co-Authors: Rahamim Avisar, Loya N, Yuval Yassur, Dov WeinbergerAbstract:BACKGROUND: Previous work has suggested an association between increasing size of Pterygium and increasing degrees of induced corneal astigmatism. OBJECTIVES: To assess the quantitative relation between Pterygium size and induced corneal astigmatism using a computerized corneal analysis system (TMS II) and slit-lamp beam evaluation of Pterygium size, and to conclude whether corneal astigmatism is an early indication for surgical intervention. METHODS: We evaluated 94 eyes of 94 patients with unilateral primary Pterygium of different sizes, using TMS II and slit-lamp beam measurements of the size of the Pterygium (in millimeters) from the limbus to assess parameters of Pterygium size with induced corneal astigmatism. Best corrected visual Snellen acuity was performed. RESULTS: Primary Pterygium induced with-the-rule astigmatism. Pterygium extending > 16% of the corneal radius or 1.1 mm or less from the limbus produced increasing degrees of induced astigmatism of more than 1.0 diopter. Significant astigmatism was found in 16.16% of 24 eyes with Pterygium of 0.2 up to 1.0 mm in size, in 45.45% of 22 eyes with Pterygium of 1.1 up to 3.0 mm in size (P or = 1.0 diopter). This significant astigmatism tends to increase with the increasing size of the lesion. Topographic astigmatism tends to be improved by successful removal of the Pterygium. These findings suggest that early surgical intervention in the Pterygium may be indicated when the lesion is more than 1.0 mm in size from the limbus.
-
Pterygium-induced corneal astigmatism.
Israel Medical Association Journal, 2020Co-Authors: Rahamim Avisar, Loya N, Yuval Yassur, Dov WeinbergerAbstract:Previous work has suggested an association between increasing size of Pterygium and increasing degrees of induced corneal astigmatism. To assess the quantitative relation between Pterygium size and induced corneal astigmatism using a computerized corneal analysis system (TMS II) and slit-lamp beam evaluation of Pterygium size, and to conclude whether corneal astigmatism is an early indication for surgical intervention. We evaluated 94 eyes of 94 patients with unilateral primary Pterygium of different sizes, using TMS II and slit-lamp beam measurements of the size of the Pterygium (in millimeters) from the limbus to assess parameters of Pterygium size with induced corneal astigmatism. Best corrected visual Snellen acuity was performed. Primary Pterygium induced with-the-rule astigmatism. Pterygium extending > 16% of the corneal radius or 1.1 mm or less from the limbus produced increasing degrees of induced astigmatism of more than 1.0 diopter. Significant astigmatism was found in 16.16% of 24 eyes with Pterygium of 0.2 up to 1.0 mm in size, in 45.45% of 22 eyes with Pterygium of 1.1 up to 3.0 mm in size (P < or = 0.0004), and in 100% of 3 eyes with Pterygium of 5.1 up to 6.7 mm in size (P = 0.0005). We found that visual acuity was decreased when topographic astigmatism was increased. When primary Pterygium reaches more than 1.0 mm in size from the limbus it induces with-the-rule significant astigmatism (> or = 1.0 diopter). This significant astigmatism tends to increase with the increasing size of the lesion. Topographic astigmatism tends to be improved by successful removal of the Pterygium. These findings suggest that early surgical intervention in the Pterygium may be indicated when the lesion is more than 1.0 mm in size from the limbus.
-
Primary Pterygium recurrence time.
Israel Medical Association Journal, 2001Co-Authors: Rahamim Avisar, Aharon Arnon, Erez Avisar, Dov WeinbergerAbstract:Background: The time to recurrence after surgical removal of primary Pterygium (Pterygium) and the association between the rate of recurrence and the postoperative interval remain unclear. Objectives: To determine the amount of follow-up time needed to identify recurrence in patients after surgical removal of Pterygium. Methods: We reviewed the files of 143 patients (143 eyes) with recurrent Pterygium to determine the interval from surgery to recurrence. Results: Almost all (91.6%) of the recurrences appeared by 360 days after surgery. Conclusions: One year is the optimal follow-up time to identify recurrence of Pterygium.
Mojtaba Meshkat - One of the best experts on this subject based on the ideXlab platform.
-
The expression of vascular endothelial growth factor in Pterygium tissue of atopic patients
International Ophthalmology, 2014Co-Authors: Hamid Gharaee, Mohammad Reza Shayegan, Mohammad Reza Khakzad, Sina Kianoush, A-reza Varasteh, Mojtaba Sankian, Mojtaba MeshkatAbstract:The exact pathogenesis of Pterygium has not been completely elucidated. Growth factors have been considered to play a role in Pterygium formation. Vascular endothelial growth factor (VEGF) is one of the principal mediators of angiogenesis, fibroblast stimulation and tissue remodeling in allergic conditions. The aim of this study was to compare the association between Pterygium and VEGF gene expression between atopic and non-atopic individuals. At first visit, all patients with Pterygium underwent blood tests, serum immunoglobulin E (IgE), serum cytokines including interleukin-4 (IL-4) and interferon-γ (IFN-γ) and peripheral blood eosinophil count. After obtaining informed consents, questionnaires were used to obtain demographic and clinical data from patients who underwent Pterygium excision surgery. Skin prick test was performed to confirm or rule out atopy in 30 patients with (case group) and 30 patients without (control group) atopy. Pterygium tissues were then removed by surgery. A semi-quantitative reverse transcriptase polymerase chain reaction was performed to determine VEGF gene expression in all patients. Our results illustrated that VEGF mRNA expression in atopic patients was significantly higher than in the non-atopic group ( P = 0.01). Eosinophil count, serum IgE and IL-4 were also significantly higher in atopic patients than in the non-atopic group ( P = 0.03, 0.001 and 0.001, respectively). However, no significant difference was noted in serum IFN-γ between the two groups ( P = 0.06). The excessive expression of VEGF gene in Pterygium tissue of patients with atopy suggests that growth factors may play a role in the pathogenesis of Pterygium or accelerate its formation.
