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Zhang L, Lyu RH, Wang JR, Shi WJ, Zheng F, Gao YY. Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note. Int J Ophthalmol 2024; 17:838-844. [PMID: 38766334 PMCID: PMC11074188 DOI: 10.18240/ijo.2024.05.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/29/2023] [Indexed: 05/22/2024] Open
Abstract
AIM To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation. METHODS Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability. RESULTS Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence. CONCLUSION ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.
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Affiliation(s)
- Ling Zhang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Run-Hua Lyu
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Jing-Ru Wang
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Wen-Jian Shi
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Feng Zheng
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ying-Ying Gao
- Department of Ophthalmology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
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Bahar A, Sabur H. Effects of injectable platelet-rich fibrin (i-PRF) on pterygium surgery with conjunctival autograft. Int Ophthalmol 2024; 44:65. [PMID: 38347311 DOI: 10.1007/s10792-024-02920-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/24/2023] [Indexed: 02/15/2024]
Abstract
OBJECTIVES To investigate the effects of subconjunctival injectable platelet-rich fibrin (i-PRF) injection on healing and complication rates after pterygium surgery with conjunctival autograft. METHODS This retrospective and comparative study evaluated 31 eyes that received i-PRF injections under the donor and graft conjunctiva following pterygium surgery, while 34 eyes did not receive i-PRF after the pterygium surgery. The patients' follow-up period was for 12 months. Postoperative recurrence, epithelial healing time, postoperative pain score, graft edema, and sliding of the graft (need for re-suturation) data were evaluated. RESULTS For the 12 months after surgery, one eye (3.2%) in the i-PRF group had developed corneal recurrence, and five eyes (14.7%) in the non-i-PRF group had developed recurrence. The mean corneal epithelial healing time was 2.96 ± 0.70 days in the i-PRF group and 3.58 ± 0.70 days in the non-i-PRF group (p = 0.001). The mean healing time of the donor conjunctiva epithelium was 3.84 ± 0.70 days in the i-PRF group, whereas it was 4.44 ± 0.74 days in the non-i-PRF group (p = 0.006). The mean postoperative pain score was 4.45 ± 1.52 in the i-PRF group and 5.08 ± 1.40 in the non-i-PRF group. In the non-i-PRF group, three cases (8.8%) required re-suturation, whereas, in the i-PRF group, no one required re-suturation. CONCLUSIONS Thanks to its platelets-derived growth factors, i-PRF can be a safe and effective adjuvant therapy for faster healing of conjunctival autograft and in the prevention of recurrence.
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Affiliation(s)
- Alperen Bahar
- Department of Ophtalmology, Diskapi Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Huri Sabur
- Department of Ophtalmology, Diskapi Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Cai Y, Fang F, Zhou T, Shi W, Cai X, Fu Y. Genetic evidence implicating circulating lipids and lipid drug targets in pterygium. Comput Struct Biotechnol J 2023; 21:5506-5514. [PMID: 38022695 PMCID: PMC10663701 DOI: 10.1016/j.csbj.2023.11.002] [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: 06/23/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed to address these questions by applying the Mendelian randomization (MR) approach. A two-step MR model was developed. In the first step, bidirectional two-sample MR was employed to establish the causal relationship between circulating lipids and pterygium risk. In the second step, drug-target MR analysis was conducted to assess the causal effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) inhibitors on pterygium outcomes. Genetically predicted low-density lipoprotein cholesterol (LDL-c) levels were found to be significantly associated with an increased risk of pterygium (Inverse variance weighted [IVW] odds ratio [OR] = 2.227; P = 1.53 × 10-4). Similarly, higher total cholesterol (TC) levels exhibited a suggestive association with greater susceptibility to pterygium (IVW OR = 1.806; P = 1.70 × 10-3). Through drug-target MR, a positive causal association was noted between HMGCR-mediated LDL-c levels and pterygium (IVW OR = 6.999; P = 0.016), suggesting that statins may be effective in reducing pterygium risk. The present findings suggest that circulating TC and LDL-c are risk factors for pterygium. Additionally, the results indicate that HMGCR inhibitors, which lower LDL-c levels, have a potential protective effect on pterygium outcomes. Further research is warranted to elucidate the underlying mechanisms involved in pterygium pathogenesis, with a particular focus on cholesterol metabolism.
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Affiliation(s)
- Yuchen Cai
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Fei Fang
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Tianyi Zhou
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Wenjun Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xueyao Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Zhang S, Yu F, Chen J, Yan D, Gong D, Chen L, Chen J, Yao Q. A thin film comprising silk peptide and cellulose nanofibrils implanting on the electrospun poly(lactic acid) fibrous scaffolds for biomedical reconstruction. Int J Biol Macromol 2023; 251:126209. [PMID: 37567522 DOI: 10.1016/j.ijbiomac.2023.126209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/08/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023]
Abstract
Conjunctival reconstruction using biocompatible polymers constitutes an effective treatment for conjunctival scarring and associated visual impairment. In this work, a thin film comprising silk peptide (SP), cellulose nanofibrils (CNF) and Ag nanoparticles (AgNPs) that implanted on the poly(lactic acid) (PLA) electrospun fibrous membranes (EFMs) was designed for biomedical reconstruction. SP and CNF as thin films can improve the surface hydrophilicity of the as-prepared scaffolds, which synergistically enhanced the biocompatibility. In in vivo experiments, the developed PLA EFMs modified with 3 wt% SP/CNF/AgNPs could be easily manipulated and transplanted onto conjunctival defects in rabbits, consequently accelerating the structural and functional restoration of the ocular surface in 12 days. Additionally, incorporation of 0.30 mg/g AgNPs efficiently reduced the topical application of antibiotics without causing infections. Thus, these resultant scaffolds could not only serve as useful alternatives for conjunctival engineering, but also prevent infections effectively with a very low content of AgNPs.
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Affiliation(s)
- Siyi Zhang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Fei Yu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Jin Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Dan Yan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Danni Gong
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Liangbo Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Junzhao Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
| | - Qinke Yao
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
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