Abstract
Background and objective
Pterygium has a high recurrence rate after simple excision, and fascial granuloma is one of the common complications of pterygium excision. This study aimed to investigate the treatment for the fascial granuloma.
Methods
In this study, the 36 eyes of 36 cases with fascial granuloma after pterygium excision were collected and divided into two groups to receive granuloma excision and conjunctival autografting or simple granuloma excision. The patients in the treatment group containing 20 cases received granuloma excision and conjunctival autografting, while the patients in the control group containing 16 cases received simple granuloma excision.
Results
The pathology examination results showed that all the removed granulomas were inflammatory granulation tissues that without bacterial infection. After 12 months’ follow-up, there was no recurrence of fascia granuloma and pterygium in the treatment group, in which the cure rate was up to 100%. In the control group, 6 cases experienced a recurrence of the granuloma fascia 2~3 weeks after operation; after further granuloma excision and conjunctival autografting, pterygium recurred in 8 cases.
Conclusion
The fascial granuloma excision with conjunctival autografting is effective and safe in treating fascial granuloma after pterygium surgery, which contributes to reducing the recurrence of pterygium.
Similar content being viewed by others
References
Tano T, Ono K, Hiratsuka Y et al (2013) Prevalence of pterygium in a population in Northern Japan: the locomotive syndrome and health outcome in Aizu Cohort Study. Acta Ophthalmol 91:232–236
Desmouliere A, Redard M, Darby I et al (1995) Apoptosis mediates the decrease in cellularity during the transition between granulation tissue and scar. Am J Pathol 146:56–66
Sibbald RG, Williamson D, Orsted HL et al (2000) Preparing the wound bed—debridement, bacterial balance and moisture balance. Ostomy Wound Manage 46:14–22 24–18, 30–15; quiz 36–17
Reinke JM, Sorg H (2012) Wound repair and regeneration. Eur Surg Res 49:35–43. https://doi.org/10.1159/000339613
Vorstenbosch J, Gallant-Behm C, Trzeciak A et al (2013) Transgenic mice overexpressing CD109 in the epidermis display decreased inflammation and granulation tissue and improved collagen architecture during wound healing. Wound Repair Regen 21:235–246. https://doi.org/10.1111/wrr.12023
Yamane T, Nakagami G, Yoshino S et al (2015) Hydrocellular foam dressings promote wound healing associated with decrease in inflammation in rat periwound skin and granulation tissue, compared with hydrocolloid dressings. Biosci Biotechnol Biochem 79:185–189. https://doi.org/10.1080/09168451.2014.968088
Martins TGDS, Costa ALFDA, Alves MR et al (2016) Mitomycin C in pterygium treatment. International Journal of Ophthalmology 9:465
Prabhasawat P, Barton K, Burkett G et al (1997) Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology 104:974
Zhang L, Wang CC (2014) Inflammatory response of macrophages in infection. Hepatobiliary Pancreat Dis Int 13:138–152
Yun-Shain L, Annette W, David W et al (2012) Wound healing in development. Birth Defects Res C Embryo Today 96:213–222
Nigwekar SP, Chaudhari SV, Gupte CP et al (2014) Pyogenic granuloma: post operative complication of pterygium surgery. International Journal of Medical Research & Health Sciences 3:759
Ozsutcu M, Ayintap E, Akkan JC et al (2014) Repeated bevacizumab injections versus mitomycin C in rotational conjunctival flap for prevention of pterygium recurrence. Indian J Ophthalmol 62:407–411
Li J, Zhou DH, Lu LN (2011) Clinical observations of conjunctival autografting combined with mitomycin C in treatment of pterygium. Journal of Shanghai Jiaotong University 31:1102–1104
Prabhasawat P, Tesavibul N, Leelapatranura K et al (2006) Efficacy of subconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium. Ophthalmology 113:1102–1109
Kasetsuwan N, Reinprayoon U, Satitpitakul V (2015) Prevention of recurrent pterygium with topical bevacizumab 0.05% eye drops: a randomized controlled trial. Clin Ther 37:2347–2351
Dong MC, Kim KH, Choi HJ et al (2012) A comparative study of the effect of fibrin glue versus sutures on clinical outcome in patients undergoing pterygium excision and conjunctival autografts. Korean Journal of Ophthalmology Kjo 26:407–413
Detorakis ET, Zaravinos A, Spandidos DA (2010) Growth factor expression in ophthalmic pterygia and normal conjunctiva. Int J Mol Med 25:513–516
Kuo CH, Miyazaki D, Yakura K et al (2010) Role of periostin and interleukin-4 in recurrence of pterygia. Invest Ophthalmol Vis Sci 51:139–143
Talghini S, Shenasi A (2013) Concomitant examination of inflammation and angiogenesis in the pathogenesis of primary moderate pterygium in a well-designed case-control study. Pakistan Journal of Biological Sciences Pjbs 16:1046–1050
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study formal consent is not required.
Rights and permissions
About this article
Cite this article
Fan, HY., Chen, ZL. The efficacy of fascial granuloma excision with conjunctival autografting after pterygium surgery. Graefes Arch Clin Exp Ophthalmol 256, 1933–1938 (2018). https://doi.org/10.1007/s00417-018-4054-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-018-4054-1