The effect of topical 0.05% cyclosporine on recurrence following pterygium surgery

Haydarpaşa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey
Clinical Ophthalmology 06/2011; 5(1):881-5. DOI: 10.2147/OPTH.S19469
Source: PubMed


To investigate the role of postoperative topical 0.05% cyclosporine A (CsA) eye drops (Restasis(®), Allergan Pharmaceutical) in the prevention of recurrence among patients with primary pterygium treated with bare-sclera technique.
In this prospective randomized controlled study, 36 eyes (34 patients) with primary pterygium were randomized into two groups: Group I comprised 18 eyes (18 patients), and Group II comprised 18 eyes (16 patients). Bare sclera technique was performed in both groups. In Group I, 0.05% CsA was administered postoperatively at 6-hour intervals for 6 months, and Group II did not receive any cyclosporine treatment. The patients were assessed for recurrence, side effects, and complications at postoperative 1 and 7 days as well as each month during the following year. Conjunctival advances which showed a limbus higher than 1 mm were recognized as recurrence.
Recurrence occurred in four patients (22.2%) in Group I and in eight (44.4%) patients in Group II.
Postoperative application of low-dose CsA can be effective for preventing recurrences after primary pterygium surgery.

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    • "To prevent recurrence, various adjunctive treatments , including chemotherapy, radiotherapy, and surgical transplants, have been employed[2]. However, according to many published studies, recurrence rates remain high following pterygium, ranging between 7.5% and 44.4% and undermining the current operative methods and adjuvant treatments345. Therefore, studies on recurrent pterygium have received more and more attentions in recent days. "
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    ABSTRACT: Objective . To examine conjunctival lymphatic vessels and to analyze the relationship between lymphangiogenesis and aggressive recurrent pterygia. Methods . Tissues from 60 excised recurrent (including 19 of Grade 1, 28 of Grade 2, and 13 of Grade 3) pterygia were used in the study. Tissues from 9 nasal epibulbar conjunctivae segments were used as controls. Pterygium slices from each patient were immunostained with LYVE-1 monoclonal antibodies to identify lymphatic microvessels in order to calculate the lymphovascular area (LVA), the lymphatic microvessel density (LMD), and the lymphovascular luminal diameter (LVL). The relationship between lymphangiogenesis (LVA, LMD, and LVL) and pterygium aggression (width, extension, and area) was clarified. Results . Few LYVE-1 positive lymphatic vessels were found in the normal epibulbar conjunctiva segments. Lymphatic vessels were slightly increased in Grades 1 and 2 and were dramatically increased in Grade 3 recurrent pterygia. The LMD was correlated with the pterygium area in Grade 1 and 2 pterygia. In Grade 3, both LVA and LMD were significantly correlated with the pterygium area. Conclusions . Lymphangiogenesis was associated with the degree of aggression in recurrent pterygia, particularly in substantial Grade 3 recurrent pterygia.
    Full-text · Article · Jan 2016 · Journal of Ophthalmology
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    • "A conservative treatment is sufficient to resolve complaints arising from an early stage pterygium, but such therapy is symptomatic and temporary [1] [9]. The artificial tears or immunomodulatory agents such as a cyclosporine drop can be used for this purpose and provide comfort and relief from foreign body sensation [9] [10]. Also, short-term antiinflammatory eye drops may also be useful for inflamed pterygia [9]. "
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    ABSTRACT: Pterygium is an abnormal fibrovascular tissue extending on the cornea which is a degenerative and hyperplastic disorder. A stromal overgrowth of fibroblast and blood vessels is accompanied by an inflammatory cell infiltrate and abnormal extracellular matrix accumulation. The surgical excision is the main treatment method of pterygium, but recurrence is the most common postoperative complication. In the present study, we aimed to compare the wide conjunctival flap and the conjunctival autografting techniques in pterygium surgery according to time of operation, safety, and effectiveness. Results showed that the effect of wide conjunctival flap techniques on primary pterygium surgery was found close to the conjunctival autograft techniques. In addition, the flap technique has a shorter surgical time, the surgery does not require extreme experience, feeding of the flap is provided with own vessels since the vascular structure is protected on the upper temporal conjunctival area, reverse placement of the flap is not seen, it needs fewer sutures, so that suture disturbances may reduce, and it is less traumatic than autograft technique during conjunctival transport. Therefore, this technique may be preferred in suitable cases.
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    ABSTRACT: To evaluate the response and cellular damage of cultured human pterygial cells according to the concentration and exposure time of topical cyclosporin.
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