Which of the following is true about pterygium
Correct Answer: Bare sclera technique has 30-60% re-currence
Description: PTERYGIUM Pterygium (L. Pterygion = a wing) is a wing-shaped fold of conjunctiva encroaching upon the cornea from either side within the interpalpebral fissure, usually on the nasal side. Etiology: environmental factors such as exposure to sun (ultraviolet rays), dry heat, high wind and abundance of dust. Pathology: Pathologically pterygium is a degenerative and hyperplastic condition of conjunctiva. The subconjunctival tissue undergoes elastotic degeneration and proliferates as vascularised granulation tissue under the epithelium, which ultimately encroaches the cornea. The corneal epithelium, Bowman&;s layer and superficial stroma are destroyed. Complications: like cystic degeneration and infection are infrequent. Rarely, neoplastic change to epithelioma, fibrosarcoma or malignant melanoma, may occur. Treatment: Surgical excision is the only satisfactory treatment. Recurrence of the pterygium after surgical excision is the main problem (30-50%). However, it can be reduced by any of the following measures: 1. Transplantation of pterygium in the lower fornix (McReynold&;s operation) is not performed now. 2. Postoperative beta irradiations (not used now). 3. Postoperative use of antimitotic drugs such as mitomycin-C or thiotepa. 4. Surgical excision with bare sclera. 5. Surgical excision with free conjunctival graft taken from the same eye or other eye is presently the preferred technique. 6. In recurrent recalcitrant pterygium, surgical excision should be coupled with lamellar keratectomy and lamellar keratoplasty. Reference :- A K KHURANA; 6th edition, page:-80,81
Category:
Ophthalmology
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