Department of Cornea and Refractive Surgery, Institute of Ophthalmology "Conde de Valenciana"-Mexico City, Mexico.
General Directorate of Epidemiology, Health Secretariat, Mexico City, Mexico.
Cornea. 2019 Nov;38(11):1339-1344. doi: 10.1097/ICO.0000000000002091.
To characterize cornea specialists' current practice preferences in the management of primary pterygium.
A 25-item survey regarding indications for surgery, surgical technique, use of adjuvant therapy, type and duration of postoperative therapy, and treatment of early recurrences was designed and sent to members of the Cornea Society through the kera-net listserv.
In total, 199 cornea specialists completed the questionnaire. More than 90% considered that surgery should be performed when there is proximity of the pterygium to the visual axis, pain or redness, eye movement restriction, or induction of astigmatism. Cosmesis was considered as an indication by 41.7% of the participants. The most frequent technique for pterygium excision was complete resection including the base and a moderate quantity of Tenon capsule followed by autologous conjunctival or limbal-conjunctival graft. The preferred graft fixation method in this survey was fibrin glue (61.2%). Most respondents reported a recurrence rate of less than 5% and no use of adjuvant agents to prevent recurrence. When early recurrence did occur, the preferred agents were corticosteroids.
This study reflects the preferences of cornea experts regarding primary pterygium treatment and may serve as a guide for the management of this pathology.
描述角膜专家在原发性翼状胬肉治疗方面的当前实践偏好。
设计了一份包含 25 个项目的调查问卷，内容涉及手术指征、手术技术、辅助治疗的应用、术后治疗的类型和持续时间以及早期复发的治疗等方面，并通过 kera-net 邮件列表向角膜学会的成员发送了该问卷。
共有 199 名角膜专家完成了问卷。超过 90%的专家认为当翼状胬肉接近视轴、出现疼痛或发红、眼球运动受限或引起散光时应进行手术。41.7%的参与者认为美容也是手术指征。翼状胬肉切除最常用的技术是完整切除，包括基底和适量的Tenon 囊，随后进行自体结膜或角膜缘结膜移植。在本调查中，首选的移植物固定方法是纤维蛋白胶（61.2%）。大多数受访者报告复发率低于 5%，且不使用辅助药物预防复发。当确实发生早期复发时，首选的药物是皮质类固醇。
本研究反映了角膜专家在原发性翼状胬肉治疗方面的偏好，可作为该疾病治疗的指南。
