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Hahner L, Jakob-Girbig J, Hasan S, Meller D. [Modified mini-SLET for treatment of complex cases in pterygium surgery]. DIE OPHTHALMOLOGIE 2024; 121:397-406. [PMID: 38502347 DOI: 10.1007/s00347-024-02014-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The major problem associated with the benign but destructive growing pterygium is the high recurrence rate. A new surgical technique to lower recurrence rates is minor ipsilateral simple limbal epithelial transplantation (mini-SLET), where the regeneration potential of limbal stem cells is used in combination with amniotic membrane transplantation (AMT) for surgical reconstruction. The aim of this study is to assess the surgical outcome of the mini-SLET technique with tenonectomy, mitomycin C, and AMT as used in the authors' hospital. MATERIALS AND METHODS A total of 16 eyes from 15 patients undergoing mini-SLET after surgical pterygium removal with tenonectomy, mitomycin C, and AMT were analyzed retrospectively. Two different groups of pterygia were enrolled: group 1 included recurrent pterygia (n = 10) and group 2 comprised primary large pterygia such as double-head pterygia (n = 6). In addition to assessment of best corrected visual acuity and compete ophthalmological examination, preoperative slip-lamp examination with photo documentation served to calculate the corneal size of the pterygium head using VISUPAC software (Zeiss, Oberkochen, Germany). Postoperatively, best corrected visual acuity and slit-lamp examination were routinely evaluated. The surgical outcome was defined by the postoperatively achieved best corrected visual acuity, restoration of the ocular surface, recurrence rate, and rate of postoperative complications. RESULTS Median follow-up in all patients was 27 months; in groups 1 and 2 it was 30.7 and 25.3 months, respectively. No recurrence developed in 15 eyes (93.75%). Only one group 1 patient (6.25%) suffered a recurrent lesion after 10 months. Postoperatively, logMAR visual acuity did not change significantly. During follow-up, complications were limited to one case of early wound dehiscence. CONCLUSION Mini-SLET in combination with tenonectomy, mitomycin C, and AMT enables good surgical reconstruction of the ocular surface, and almost complete healing in the sense of restitutio ad integrum is possible. The results of the present study have shown the technique's effectiveness for recurrence prevention.
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Affiliation(s)
- Luise Hahner
- Klinik für Augenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - Juliane Jakob-Girbig
- Klinik für Augenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - Somar Hasan
- Klinik für Augenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
| | - Daniel Meller
- Klinik für Augenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
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2
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Auw-Hädrich C, Gasser L, Reinhard T. Bindehautdegenerationen und -neoplasien. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1488-0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungErhabenheiten der Bindehaut entstehen durch Gewebevermehrung, die entweder degenerativ oder neoplastisch, aber auch entzündlich sein können. In diesem Artikel werden degenerative (Pterygium
und Pinguecula) sowie benigne und maligne neoplastische Bindehautveränderungen (epitheliale, melanozytäre und vaskuläre Tumoren, Choristome sowie Metastasen) bezüglich der Pathogenese,
Symptome, Diagnostik und aktuellem Stand der Behandlung dargestellt.
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3
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Auw-Hädrich C, Gasser L, Reinhard T. [Conjunctival Degeneration and Neoplasia]. Klin Monbl Augenheilkd 2022; 239:823-845. [PMID: 35609810 DOI: 10.1055/a-1831-2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Conjunctival tumors result from gain of tissue, which can be either degenerative or neoplastic, but also inflammatory. In this article, degenerative (pterygium and pinguecula) as well as benign and malignant neoplastic conjunctival changes (epithelial, melanocytic and vascular tumors, choristomas as well as metastases) are discussed with regard to pathogenesis, symptoms, diagnostics and current status of treatment.
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4
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Chan HN, Zhang XJ, Ling XT, Bui CHT, Wang YM, Ip P, Chu WK, Chen LJ, Tham CC, Yam JC, Pang CP. Vitamin D and Ocular Diseases: A Systematic Review. Int J Mol Sci 2022; 23:ijms23084226. [PMID: 35457041 PMCID: PMC9032397 DOI: 10.3390/ijms23084226] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
The contributory roles of vitamin D in ocular and visual health have long been discussed, with numerous studies pointing to the adverse effects of vitamin D deficiency. In this paper, we provide a systematic review of recent findings on the association between vitamin D and different ocular diseases, including myopia, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), dry eye syndrome (DES), thyroid eye disease (TED), uveitis, retinoblastoma (RB), cataract, and others, from epidemiological, clinical and basic studies, and briefly discuss vitamin D metabolism in the eye. We searched two research databases for articles examining the association between vitamin D deficiency and different ocular diseases. One hundred and sixty-two studies were found. There is evidence on the association between vitamin D and myopia, AMD, DR, and DES. Overall, 17 out of 27 studies reported an association between vitamin D and AMD, while 48 out of 54 studies reported that vitamin D was associated with DR, and 25 out of 27 studies reported an association between vitamin D and DES. However, the available evidence for the association with other ocular diseases, such as glaucoma, TED, and RB, remains limited.
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Affiliation(s)
- Hei-Nga Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
| | - Xiu-Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
| | - Xiang-Tian Ling
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
| | - Christine Huyen-Trang Bui
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
| | - Yu-Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China;
| | - Wai-Kit Chu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Li-Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Clement C. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
- Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
- Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
- Correspondence: (J.C.Y.); (C.-P.P.)
| | - Chi-Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; (H.-N.C.); (X.-J.Z.); (X.-T.L.); (C.H.-T.B.); (Y.-M.W.); (W.-K.C.); (L.-J.C.); (C.C.T.)
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: (J.C.Y.); (C.-P.P.)
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5
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Roth M, Herrmann ME, Geerling G, Guthoff R. [Current and future effects of climate change on ophthalmology]. Ophthalmologe 2022; 119:552-560. [PMID: 35294593 DOI: 10.1007/s00347-022-01594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Climate change is also an increasingly important issue in the healthcare system. Due to its anatomical and physiological nature, the eye is directly exposed to environmental influences and changes in a special way. METHODS The current literature is used to illustrate the effects of climate-induced changes and the respective influences on the eye. A PubMed search (cut-off date 3 October 2021) using the search terms "climate change" or "planetary health" or "global health" and in each case "ophthalmology" or "eye" or "ocular" was used to determine the development of the number of publications between 2011 and 2021. RESULTS Measurable effects of climate change are already evident in a wide variety of ophthalmological fields. The significance of this topic, for instance, is reflected in a relatively constant increase in the number of publications and an almost tenfold increase in the number of publications per year from 2011 to 2021. CONCLUSION The impact of climate change on eye diseases and on the field of ophthalmology is multifaceted and could be expected to intensify in the coming years. Therefore, the interrelationships need to be further investigated in future studies, preferably on a large scale.
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Affiliation(s)
- M Roth
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - M E Herrmann
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - G Geerling
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - R Guthoff
- Universitätsaugenklinik Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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6
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Omar AR, Ibrahim M, Jaafar H, Siti-Azrin AH, Zunaina E. Evaluation of Cyclooxygenase-2 and p53 Expression in Pterygium Tissue Following Preoperative Intralesional Ranibizumab Injection. Front Med (Lausanne) 2022; 8:733523. [PMID: 35004714 PMCID: PMC8739785 DOI: 10.3389/fmed.2021.733523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Overexpression of vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), and p53 are the postulated aetiopathogenesis in pterygium. VEGF is responsible for the induction of COX-2 expression, whereas p53 plays an important role in the regulation of VEGF. This study aimed to evaluate the immunohistochemistry of COX-2 and p53 expressions from excised pterygium tissue from patients who received intralesional ranibizumab (anti-VEGF) injection 2 weeks prior to pterygium surgery. Materials and Methods: An interventional comparative study involving patients presenting with primary pterygium was conducted between September 2015 and November 2017. The patients were randomized into either the intervention or control group. Patients in the intervention group were injected with intralesional ranibizumab (0.5 mg/0.05 ml) 2 weeks prior to surgery. Both groups underwent pterygium excision followed by conjunctival autograft. Immunohistochemistry staining was performed to evaluate COX-2 and p53 expressions in the excised pterygium tissue. Results: A total of 50 patients (25 in both the intervention and control groups) were recruited. There were 34 (68%) patients with grade III pterygium and 16 (32%) patients with grade IV pterygium. There was statistically significant difference in reduction of COX-2 expression in the epithelial layer [84.0% (95% CI: 63.9, 95.5)] (p = 0.007) and stromal layer [84.0% (95% CI: 63.9, 95.5)] (p < 0.001) between intervention and control groups. There was no significant difference in the reduction of p53 expression between the two groups. Conclusion: This study demonstrated the possible use of intralesional anti-VEGF treatment prior to pterygium excision as a potential future modality of adjunctive therapy for pterygium surgery.
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Affiliation(s)
- Ahmad Razif Omar
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Mohtar Ibrahim
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Hasnan Jaafar
- Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Ab Hamid Siti-Azrin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Embong Zunaina
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
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7
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Thompson JP, Harbin Z, Das H, Deschner LA, Seale SA, Kheirkhah A. Comparison of Pterygium Recurrence Rates Between Attending Physicians and Supervised Trainee Residents. Cornea 2022; 41:12-15. [PMID: 34870620 DOI: 10.1097/ico.0000000000002721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the recurrence rates after pterygium surgery performed by supervised trainee residents and attending physicians. METHODS This retrospective study included pterygium surgeries performed by trainee residents and attending physicians in an academic institution in South Texas in the years 2008 to 2019. All residents performed surgeries under direct supervision of an attending physician. Only primary pterygium cases with a minimum postoperative follow-up of 6 months were included. Patients' demographics, primary surgeon, use of conjunctival autograft (CAU) or amniotic membrane graft (AMG), recurrence of pterygium, follow-up length, and complications were recorded. RESULTS This study included 240 eyes of 229 patients with a mean age of 55.6 ± 12.3 years (range, 28-91 years). Of these eyes, 100 surgeries were performed by attending physicians (including 87 with CAU and 13 with AMG) and 140 surgeries by trainee residents (including 119 with CAU and 21 with AMG). There were no significant differences between the 2 groups of patients regarding age, sex, and surgical technique (CAU vs. AMG). Patients were followed up for an average of 19.8 ± 15.2 months. No statistically significant differences were found in comparing the rate of pterygium recurrence between attending physicians and residents when using CAU (6.8% vs. 10.0%, respectively; P = 0.42) and AMG (69.2% vs. 47.6%, respectively; P = 0.22). Moreover, there were no significant differences in other postoperative complications between the groups. CONCLUSIONS Pterygium recurrence rates were similar between attending physicians and supervised trainee residents. Thus, acceptable outcomes can be expected when pterygium surgery is performed by a supervised ophthalmology resident.
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Affiliation(s)
- John P Thompson
- Department of Ophthalmology, Louisiana State University at New Orleans, New Orleans, LA; and
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
| | - Zach Harbin
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
| | - Hrishikesh Das
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
| | - Lauren A Deschner
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
| | - Stephanie A Seale
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
| | - Ahmad Kheirkhah
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX
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8
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Hampel U, Elflein HM, Kakkassery V, Heindl LM, Schuster AK. [Alterations of the anterior segment of the eye caused by exposure to UV radiation]. Ophthalmologe 2021; 119:234-239. [PMID: 34860283 DOI: 10.1007/s00347-021-01531-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND By identifying diseases of the anterior segment of the eye associated with exposure to UV light, recommendations for action can be derived. AIM After reading this review, the reader should be familiar with UV light-associated diseases of the anterior segment of the eye. METHOD Using a selective literature search, UV light-associated diseases of the anterior segment of the eye were identified and protective mechanisms are described. RESULTS The UV light-associated lesions of the anterior segment of the eye include basal cell and squamous cell carcinomas, malignant melanoma of the eyelids and conjunctiva, pterygium, keratoconjunctivitis photoelectrica and climatic droplet keratopathy as well as cortical cataract. CONCLUSION Eyeglasses for filtering UV light, sunglasses and special safety glasses, such as welding helmets and wearing headgear protect against UV light exposure to the anterior segment of the eye and the associated diseases.
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Affiliation(s)
- Ulrike Hampel
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland. .,Klinik und Poliklinik für Augenheilkunde, Universität Leipzig, Leipzig, Deutschland.
| | - Heike M Elflein
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland
| | - V Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - Ludwig M Heindl
- Klinik für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.,Center for Integrated Oncology (CIO) Aachen-Bonn-Köln-Düsseldorf, Köln, Deutschland
| | - Alexander K Schuster
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland
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9
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[Pterygium and pinguecula]. Ophthalmologe 2021; 118:1163-1164. [PMID: 34542693 DOI: 10.1007/s00347-021-01502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
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10
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Rokohl AC, Heindl LM, Cursiefen C. [Pterygium: pathogenesis, diagnosis and treatment]. Ophthalmologe 2021; 118:749-763. [PMID: 33782734 DOI: 10.1007/s00347-021-01366-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 12/30/2022]
Abstract
The pterygium is a frequent ultraviolet (UV) light-induced focal fibrovascular proliferation of the conjunctival tissue onto the cornea. Surgical excision should be performed in the case of reduced visual acuity, progressive astigmatism, impending invasion of the optical axis and ocular surface complaints. The main factors in preventing recurrence include optimal surgical treatment by an excision combined with a free conjunctival autograft, consistent postoperative treatment with preservative-free artificial tears and topical steroids as well as long-term UV protection.
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Affiliation(s)
- Alexander C Rokohl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
| | - Ludwig M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland
| | - Claus Cursiefen
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland.,Zentrum für Molekulare Medizin Köln (ZMMK), Universität zu Köln, Köln, Deutschland
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11
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Das AV, Podila S, Prashanthi GS, Basu S. Clinical profile of pterygium in patients seeking eye care in India: electronic medical records-driven big data analytics report III. Int Ophthalmol 2020; 40:1553-1563. [PMID: 32096104 DOI: 10.1007/s10792-020-01326-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/15/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the clinical profile of pterygium in patients presenting to a multi-tier ophthalmology hospital network in India. METHODS This cross-sectional hospital-based study included 1,610,843 new patients presenting between 2010 and 2019. Patients with a clinical diagnosis of pterygium in at least one eye were included as cases. The data were collected using an electronic medical record system. Multiple logistic regression analysis with odds ratios (OR) was performed to identify the associated risk factors. RESULTS Overall, 168,807 (10.5%) new patients were diagnosed with pterygium, of which 43,692 (26%) patients complained about the lesion. The prevalence rates were 0.7% in children and 12.6% in adults. Majority of patients were female (54.5%) and had unilateral (57%) affliction. Among the 241,631 affected eyes, the pterygia were primary in 99.6%, nasally located in 94%, and were grade I-II in 84.8%. Four in 5 eyes did not have any cylindrical refractive error, and 44% had coexistent cataract. Pterygium surgery was indicated in 10.3% eyes. Female sex (OR 1.37), increasing age (OR 19.5), rural residence (OR 1.21), agriculture work (OR 2.19), manual labor (OR 2.05), low socioeconomic status (OR 2.14) and geographical location closer to the equator (OR 3.4) were identified as the risk factors for developing pterygium. CONCLUSION About one-tenth of individuals seeking eye care in India have pterygium in at least one eye. It rarely impacts vision, is commonly unilateral and nasal and usually does not require surgery. It is associated with increasing age, females, outdoor work, low income and geographical location closer to the equator.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sahitya Podila
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Gumpili Sai Prashanthi
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India. .,Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India.
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12
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Zhang LM, Lu Y, Gong L. Pterygium Is Related to Short Axial Length. Cornea 2020; 39:140-145. [PMID: 31714404 PMCID: PMC6970537 DOI: 10.1097/ico.0000000000002200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length. METHODS A retrospective, hospital-based cross-sectional study included 521 eyes from 521 patients who were enrolled through a community survey by Shanghai Heping Eye Hospital was conducted. Patients with primary pterygium in at least 1 eye were considered the pterygium group, and those with normal eyes were considered the nonpterygium group. The prevalence and length of pterygium, refractive characteristics including spherical power, astigmatism, corneal curvature, and anatomical parameters including axial length, anterior chamber depth, endothelial cell density, and corneal thickness were compared between groups. RESULTS Five hundred twenty-one eyes of 521 patients (214 men and 307 women) with a mean age of 70.5 ± 7.6 years were included in the study. The prevalence of hyperopia (81.6%, 65.1%, P = 0.001), axial length (23.1 ± 1.2 mm, 24.2 ± 2.4 mm, P < 0.001), anterior chamber depth (2.9 ± 0.3 cm, 3.1 ± 0.4 cm, P = 0.001), flat K value (42.94 ± 2.16 diopters, 43.73 ± 1.48 diopters, P = 0.002), Kmax (51.13 ± 7.74 diopters, 47.49 ± 5.62 diopters, P < 0.001), and spherical power (0.97 ± 2.40 diopters, -0.82 ± 4.40 diopters, P < 0.001) were statistically different between the pterygium and nonpterygium groups. Age (r = -0.21, P = 0.025), corneal astigmatism (r = -0.41, P < 0.001), flat K value (r = -0.39, P < 0.001), and endothelial cell density (r = -0.33, P = 0.001) were all negatively correlated with the length of pterygium. The prevalence of pterygium and severe pterygium over 3 mm were statistically different according to the severity of hyperopia (P < 0.001) and axial length (P < 0.001). Stratified χ analysis showed that axial length, rather than hyperopia, was a related factor to pterygium (odds ratio = 5.23, 95% confidence interval: 2.50-10.93). CONCLUSIONS We conclude from our study that the prevalence of pterygium is related to small eye size. SDF-1/CXCR4 signaling may play a vital role in pterygium and shorter axial length. Further study focused on SDF-1/CXCR4 signaling will be needed.
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Affiliation(s)
- Li Mei Zhang
- Department of Ophthalmology, Heping Eye Hospital, Shanghai, China;
| | - Yang Lu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; and
- Key Laboratory of Myopia, Ministry of Health, Shanghai, China
| | - Lan Gong
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; and
- Key Laboratory of Myopia, Ministry of Health, Shanghai, China
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Guo Q, Li X, Cui MN, Liang Y, Li XP, Zhao J, Wei LN, Zhang XL, Quan XH. Low-Dose Mitomycin C Decreases the Postoperative Recurrence Rate of Pterygium by Perturbing NLRP3 Inflammatory Signalling Pathway and Suppressing the Expression of Inflammatory Factors. J Ophthalmol 2019; 2019:9472782. [PMID: 31827916 PMCID: PMC6885197 DOI: 10.1155/2019/9472782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/02/2019] [Accepted: 08/07/2019] [Indexed: 01/20/2023] Open
Abstract
A pterygium is generally believed to be a chronic inflammatory lesion caused by external stimuli that develops from the conjunctiva and grows onto the cornea. Simple bare sclera excision is the most commonly used method to treat pterygium. However, the high postoperative recurrence rate of pterygium remains a persistent challenge. Mitomycin C (MMC) is an antineoplastic antibiotic that inhibits DNA, RNA, and protein synthesis. In recent years, although MMC has proven useful for the treatment of pterygium, its application has been controversial because of its clear toxicity and the possibility of ocular complications. In the current study, we prospectively recruited patients to receive or not receive a local injection of MMC (0.4 mg/ml). Follow-up was conducted with the patients to determine the postoperative recurrence rate of pterygium and/or to observe any ocular complications. The remarkable results demonstrated that MMC can decrease the postoperative recurrence rate of pterygium without leading to serious eye complications. Further results indicated that MMC can inhibit the activation of the NLRP3 inflammatory signalling pathway and thus downregulate the expression of downstream molecules, including IL-18 and IL-1β. MMC also reduced the expression of inflammatory factors TGF-β1, VEGF, and IL-6. In addition to influencing these factors, MMC suppressed neovascularization and the proliferation of corneal fibroblasts to effectively reduce the recurrence rate of pterygium. Taken together, our results provide a theoretical basis for the development of prevention and treatment strategies for pterygium and suggest that MMC is highly effective as an adjunctive treatment after excision of primary pterygia.
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Affiliation(s)
- Qie Guo
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Xiao Li
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Meng-Na Cui
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Yu Liang
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Xiang-Peng Li
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Jun Zhao
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Li-Na Wei
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Xiao-Lei Zhang
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
| | - Xiang Hua Quan
- Department of Clinical Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China
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14
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Bamdad S, Kooshki AS, Yasemi M. Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial. Electron Physician 2017; 9:5877-5884. [PMID: 29560137 PMCID: PMC5843411 DOI: 10.19082/5877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 08/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background 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. Objective 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. Methods 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 complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21. Results The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation’s outcome (p=0.017). Conclusion CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva. Clinical trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016092119581N2. Funding The study was financially supported by Shiraz University of Medical Sciences (SUMS) (grants No. 8901).
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Affiliation(s)
- Shahram Bamdad
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anis Shamsi Kooshki
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Yasemi
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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15
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Clearfield E, Hawkins BS, Kuo IC. Conjunctival Autograft Versus Amniotic Membrane Transplantation for Treatment of Pterygium: Findings From a Cochrane Systematic Review. Am J Ophthalmol 2017; 182:8-17. [PMID: 28734814 DOI: 10.1016/j.ajo.2017.07.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/07/2017] [Accepted: 07/09/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To summarize key findings from a systematic review of the effectiveness and risks of conjunctival autograft (CAG) compared with amniotic membrane transplant (AMT) for pterygium. DESIGN Cochrane systematic review. METHODS We included only randomized controlled trials (RCTs) in which CAG and AMT had been compared for primary or recurrent pterygia. The primary outcome was recurrence of pterygium ≥1 mm onto the cornea by 3 and 6 months post surgery. We adhered to Cochrane methods for trial selection, data extraction, risk of bias evaluation, and data synthesis. RESULTS Twenty RCTs with 1866 participants (1947 eyes) were included. Pterygium recurrence 6 months after surgery ranged from 3.3% to 16.7% in the CAG group and 6.4% to 42.3% in the AMT group based on data from 1021 eyes in 10 RCTs. Estimated risk ratios from meta-analysis indicated that CAG-treated eyes had a 47% lower risk of recurrence 6 months after surgery compared with the AMT group (RR, 0.53, 95% confidence interval [CI], 0.33-0.85). For 96 eyes with recurrent pterygium, the risk of recurrence 6 months after CAG was reduced by 55% compared with AMT (risk ratio [RR], 0.45, 95% CI, 0.21-0.99). Three-month recurrence rates were similar for CAG and AMT based on data from 538 eyes (6 RCTs). CONCLUSIONS CAG was more effective than AMT to prevent pterygium recurrence by 6 months post surgery, especially in recurrent pterygia. CAG-treated eyes had half the recurrence rates of AMT-treated eyes. Future RCTs should assess changes in patient-reported outcomes (symptoms, cosmesis) and visual acuity, and evaluate effects of surgical variations.
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16
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Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, Willcox MDP. TFOS DEWS II Sex, Gender, and Hormones Report. Ocul Surf 2017; 15:284-333. [PMID: 28736336 DOI: 10.1016/j.jtos.2017.04.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/16/2017] [Indexed: 12/21/2022]
Abstract
One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.
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Affiliation(s)
- David A Sullivan
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
| | - Eduardo M Rocha
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Pasquale Aragona
- Department of Biomedical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Sicily, Italy
| | - Janine A Clayton
- National Institutes of Health Office of Research on Women's Health, Bethesda, MD, USA
| | - Juan Ding
- Schepens Eye Research Institute, Massachusetts Eye & Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Ulrike Hampel
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alison M McDermott
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, USA
| | - Debra A Schaumberg
- Harvard School of Public Health, Boston, MA, USA; University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sruthi Srinivasan
- Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada
| | - Piera Versura
- Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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17
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Wu CW, Peng ML, Yeh KT, Tsai YY, Chiang CC, Cheng YW. Inactivation of p53 in pterygium influence miR-200a expression resulting in ZEB1/ZEB2 up-regulation and EMT processing. Exp Eye Res 2016; 146:206-211. [DOI: 10.1016/j.exer.2016.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/10/2016] [Accepted: 03/13/2016] [Indexed: 01/07/2023]
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Abstract
BACKGROUND 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 from which the pterygium was excised. Another type of tissue graft surgery for pterygium is amniotic membrane graft, whereby a piece of donor amniotic membrane is fixed to the remaining limbus and bare sclera area after the pterygium has been excised. OBJECTIVES The objective of this review was to assess the safety and effectiveness of conjunctival autograft (with or without adjunctive therapy) compared with amniotic membrane graft (with or without adjunctive therapy) for pterygium. We also planned to determine whether use of MMC yielded better surgical results and to assess the direct and indirect comparative costs of these procedures. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 10, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2015), EMBASE (January 1980 to November 2015), PubMed (1948 to November 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to November 2015), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 21 November 2014), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 23 November 2015. SELECTION CRITERIA We included in this review randomized controlled trials that had compared conjunctival autograft surgery (with or without adjunctive therapy) with amniotic membrane graft surgery (with or without adjunctive therapy) in people with primary or recurrent pterygium. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results and assessed full-text reports from among the potentially eligible trials. Two review authors independently extracted data from the included trials and assessed the trial characteristics and risk of bias. The primary outcome was the risk of recurrence of pterygium at 3 months and 6 months after surgery. We combined results from individual studies in meta-analyses using random-effects models. Risk of recurrence of pterygium was reported using risk ratios to compare conjunctival autograft with amniotic membrane transplant. MAIN RESULTS We identified 20 studies that had analyzed a total of 1947 eyes of 1866 participants (individual studies ranged from 8 to 346 participants who were randomized). The studies were conducted in eight different countries: one in Brazil, three in China, three in Cuba, one in Egypt, two in Iran, two in Thailand, seven in Turkey, and one in Venezuela. Overall risk of bias was unclear, as many studies did not provide information on randomization methods or masking to prevent performance and detection bias.The risk ratio for recurrence of pterygium using conjunctival autograft versus amniotic membrane transplant was 0.87 (95% confidence interval (CI) 0.43 to 1.77) and 0.53 (95% CI 0.33 to 0.85) at 3 months and 6 months, respectively. These estimates include participants with primary and recurrent pterygia. We performed a subgroup analysis to compare participants with primary pterygia with participants with recurrent pterygia. For participants with primary pterygia, the risk ratio was 0.92 (95% CI 0.37 to 2.30) and 0.58 (95% CI 0.27 to 1.27) at 3 months and 6 months, respectively. We were only able to estimate the recurrence of pterygia at 6 months for participants with recurrent pterygia, and the risk ratio comparing conjunctival autograft with amniotic membrane transplant was 0.45 (95% CI 0.21 to 0.99). One included study was a doctoral thesis and did not use allocation concealment. When this study was excluded in a sensitivity analysis, the risk ratio for pterygium recurrence at 6 months' follow-up was 0.43 (95% CI 0.30 to 0.62) for participants with primary and recurrent pterygium. One of the secondary outcomes, the proportion of participants with clinical improvement, was analyzed in only one study. This study reported clinical outcome as the risk of non-recurrence, which was seen in 93.8% of participants in the conjunctival limbal autograft group and 93.3% in the amniotic membrane transplant group at 3 months after surgery.We did not analyze data on the need for repeat surgery, vision-related quality of life, and direct and indirect costs of surgery due to an insufficient number of studies reporting these outcomes.Thirteen studies reported adverse events associated with conjunctival autograft surgery and amniotic membrane transplant surgery. Adverse events that occurred in more than one study were granuloma and pyogenic granuloma and increased intraocular pressure. None of the included studies reported that participants had developed induced astigmatism. AUTHORS' CONCLUSIONS In association with pterygium excision, conjunctival autograft is associated with a lower risk of recurrence at six months' after surgery than amniotic membrane transplant. Participants with recurrent pterygia in particular have a lower risk of recurrence when they receive conjunctival autograft surgery compared with amniotic membrane transplant. There are few studies comparing the two techniques with respect to visual acuity outcomes, and we identified no studies that reported on vision-related quality of life or direct or indirect costs. Comparison of these two procedures in such outcome measures bears further investigation. There were an insufficient number of studies that used adjunctive mitomycin C to estimate the effects on pterygium recurrence following conjunctival autograft or amniotic membrane transplant.
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Affiliation(s)
- Elizabeth Clearfield
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetRoom 6014BaltimoreMarylandUSA21205
| | - Valliammai Muthappan
- Wilmer Eye Institute, Johns Hopkins University School of MedicineDepartment of Ophthalmology600 North Wolfe StreetBaltimoreMarylandUSA21287
| | - Xue Wang
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe StreetRoom 6014BaltimoreMarylandUSA21205
| | - Irene C Kuo
- Wilmer Eye Institute, Johns Hopkins University School of MedicineDepartment of Ophthalmology600 North Wolfe StreetBaltimoreMarylandUSA21287
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Prevalence and risk factors for pterygium in rural older adults in Shandong Province of China: a cross-sectional study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:658648. [PMID: 25165711 PMCID: PMC4140101 DOI: 10.1155/2014/658648] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/26/2014] [Accepted: 05/26/2014] [Indexed: 11/18/2022]
Abstract
To investigate the prevalence and risk factors for pterygium in rural older adults in Shandong Province, eastern China, a population-based, cross-sectional study was performed from April to July 2008. By means of cluster random sampling methods, a total of 19,583 people aged 50 years or above were randomly selected from four rural counties. Out of 19,583 people, 1,767 residents were excluded mainly because they were migrant workers when this study was performed. Finally, 17,816 (90.98%) people were included as eligible subjects. They received a comprehensive eye examination and a structured questionnaire voluntarily. Patients with pterygium were defined as having pterygium at the time of survey or pterygium surgery had been performed. 1,876 people were diagnosed as pterygium, either unilateral (1,083) or bilateral (793), which is equivalent to a prevalence of 10.53% (95% CI, 10.08–10.98). The multivariate logistic regression analysis showed that pterygium was independently associated with older age, areas, outdoor time, educational level, and use of hat and/or sunglasses. The prevalence of pterygium increased with age and hours spent under sunshine per day. Meanwhile, the higher the educational level and the more use of hat and/or sunglasses, the lower the pterygium prevalence.
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