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Purpose: To propose the optimal value of baseline corneal astigmatism and pterygial morphological profiles for primary pterygium surgery to restore the corneal optical properties. Methods: We analysed 93 eyes from 84 subjects with nasal‐only primary pterygium who underwent pterygium excision with conjunctival‐limbal autograft and were assessed perioperatively using anterior segment swept‐source optical coherence tomography (AS SS‐OCT). We collected data on anterior corneal astigmatism (ACA) and root mean square (RMS) values for anterior corneal lower‐ (LoA) and higher‐order aberrations (HoA) as corneal optical properties using AS SS‐OCT. Using preoperative ACA and four pterygial morphological profiles (horizontal invasion length [HIL], height, thickness and the ratio of residual corneal thickness [RCT] to central corneal thickness [CCT]) measured in AS SS‐OCT, we plotted receiver operating characteristic (ROC) curves. These curves aimed to determine cut‐off values predicting a perioperative decrease exceeding 50% in ACA, RMS LoA and RMS HoA, as well as postoperative residual ACA higher than 1.25D. Results: Preoperative ACA > 1.42D (AUC = 0.934) and >3.60D (AUC = 0.946) proved most effective in identifying subjects with perioperative decrease exceeding in ACA and RMS LoA, respectively. HIL > 3.34 mm (AUC = 0.941) was most effective in distinguishing subjects with perioperative reduction exceeding 50% in RMS HoA. Preoperative ACA > 5.78D (AUC = 0.776) and HIL > 5.03 mm (AUC = 0.700) significantly distinguished subjects with postoperative residual ACA higher than 1.25D. Conclusion: Optimizing the restoration of corneal astigmatism and aberrations after pterygium surgery may be facilitated by determining the optimal surgical timing based on preoperative ACA and HIL values. [ABSTRACT FROM AUTHOR]

ABSTRACT Eruptive melanocytic nevi (EMN) have been reported in the setting of immunosuppression, chemotherapy, and bullous skin disease, including less commonly, Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). This case report presents a 4‐year‐old girl who developed agminated EMN and nail changes after TEN. A systematic review of the literature supports clinically appropriate follow‐up of EMN, as there is no reports of malignancy in EMN following SJS/TEN, nor reports of pediatric melanoma arising within EMN of any etiology. Further study of the possible correlation of nail changes with the development of EMN and better characterization of the dermoscopic features of EMN could improve monitoring and care of these patients. [ABSTRACT FROM AUTHOR]

Background: The utilities of anterior segment optical coherence tomography (AS-OCT) for characterization, differential diagnosis, postoperative monitoring, and evaluation/comparison of surgical techniques in pterygium are described. Through AS-OCT, it is also possible to study the corneal astigmatic effect of pterygium. Our purpose is to study the associations between the anatomical characteristics of pterygium and the corneal topography through AS-OCT. Methods: Fifty eyes with primary pterygium in a tertiary hospital were evaluated before surgery by measuring 10 anatomical variables of pterygium and 13 topographic variables using AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan). Statistical analysis was used to study the association between them. Results: Pterygium classified as flat pattern exhibited lower preoperative values of flat keratometry (K1), real flat keratometry (K1r), average keratometry (AvgK), and real average keratometry (AvgKr) compared to nodular ones. The flat pattern showed greater cylinder (CYL) and real cylinder (CLYr) values. The horizontal corneal invasion proportionally increased CYL and CYLr. Overall, larger anatomical pterygium measurements (limbus thickness (LimbusT), central pterygium thickness (CentreT), head pterygium thickness (HeadT), epithelial thickness at 1 mm (EpitT1mm), stromal thickness at 1 mm (stromT1mm), total thickness at 1 mm (TotalT1mm), total thickness at 2 mm (TotalT2mm), and total thickness at 3 mm (TotalT3mm)) resulted in lower anterior K1, K1r, AvgK, and AvgKr, and posterior K1 and AvgK values. CentreT was greater in astigmatisms against the rule than in oblique ones. Conclusions: This study demonstrates associations between preoperative topography and the NF (nodular or flat) classification of pterygium and its anatomical measurements assessed by AS-OCT. [ABSTRACT FROM AUTHOR]

Arthrogryposis is a clinical feature defined by congenital joint contractures in two or more different body areas which occurs in between 1/3000 and 1/5000 live births. Variants in multiple genes have been associated with distal arthrogryposis syndromes. Heterozygous variants in MYH3 have been identified to cause the dominantly‐inherited distal arthrogryposis conditions, Freeman–Sheldon syndrome, Sheldon–Hall syndrome, and multiple pterygium syndrome. In contrast, MYH3 variants underlie both dominantly and recessively inherited Contractures, Pterygia, and Spondylocarpotarsal Fusion syndromes (CPSFS) which are characterized by extensive bony abnormalities in addition to congenital contractures. Here we report two affected sibs with distal arthrogryposis born to unaffected, distantly related parents. Sequencing revealed that both sibs were homozygous for two ultra‐rare MYH3 variants, c.3445G>A (p.Glu1149Lys) and c.4760T>C (p.Leu1587Pro). Sequencing and deletion/duplication analysis of 169 other arthrogryposis genes yielded no other compelling candidate variants. This is the first report of biallelic variants in MYH3 being implicated in a distal arthrogryposis phenotype without the additional features of CPSFS. Thus, akin to CPSFS, both dominant and recessively inherited distal arthrogryposis can be caused by variants in MYH3. [ABSTRACT FROM AUTHOR]

The protein epidermal growth factor (EGF), which plays a crucial role in promoting cell proliferation and survival, has recently demonstrated potential in reducing inflammation. In this study, we examined the impact of EGF on the anti-inflammatory and anti-proliferative properties of pterygium, a prevalent hypervascular proliferative disease affecting the ocular surface. In surgically excised tissues, markers for fibrotic and inflammatory signals, including VIM, ACTA2, FAP, MMP2, VCAM1, ICAM1, CD86, IL6, and IL1B were upregulated in the pterygium body stroma compared to the normal conjunctival stroma. EGF exerted anti-inflammatory and anti-vasculogenic effects on pterygial fibroblasts when co-cultured with M1 macrophages. Moreover, exosomes derived from EGF-preconditioned M1 macrophages suppressed the heightened inflammatory and vasculogenic signals in pterygial fibroblasts induced by exosomes from M1 macrophages. Paradoxically, the proliferation of pterygial fibroblasts was inhibited by EGF in the in vitro microenvironment with M1 macrophages, despite EGF being known as a growth factor. EGF-preconditioning of M1 macrophages rescued the increased proliferation of pterygial fibroblasts induced by exosomes from M1 macrophages. In conclusion, our findings demonstrate that EGF effectively mitigates inflammation and proliferation in pterygial fibroblasts within a microenvironment containing M1 macrophages. [ABSTRACT FROM AUTHOR]

Objective To observe the proliferation, apoptosis, invasion, and migration of human ocular conjunctival pterygium (ocular pathological scar) fibroblasts and human anterior thoracic skin pathological scars (skin-derived pathological scars) fibroblasts cultured in resveratrol-containing medium, in order to investigate the effects of resveratrol on the proliferation, apoptosis, invasion, and migration of human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts. Methods Primary human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts were isolated by tissue block adherent method. The cell viability (OD value) of human ocular and skin-derived pathological scar fibroblasts was detected by CCK-8 when the cells were cultured in media containing 0 (control), 1, 2, 4, 8, 16, 32, 64,128 and 256 µg/mL resveratrol for 48 h. Human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts were cultured with 0 and 75 µg/mL resveratrol for 8 h, and the apoptosis rate was measured by Tunel method. These two kinds fibroblasts were cultured in 0 and 30 µg/mL resveratrol media for 48 h, and the migration and invasion abilities of the cells (the number of invasive migratory cells) were observed. Results The OD values of human ocular pathological scar fibroblasts cultured in media containing 128 and 256 µg/mL resveratrol decreased (both P<0. 05), and the OD values of skin-derived pathological scar fibroblasts cultured in media containing 64, 128, and 256 µg/ mL resveratrol all decreased (all P<0. 05), in comparison with those at 0 µg/mL resveratrol. Compared with those at 0 µg/mL resveratrol, the apoptosis rates of human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts cultured in 75 µg/mL resveratrol medium increased (all P<0. 05), and the number of invasion and migration cells of human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts cultured in medium containing 30 µg/mL resveratrol became smaller (all P<0. 01) . Conclusions Human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts cultured in resveratrol-containing medium have reduced viability, invasion, and migration abilities, and increased apoptosis rate. Resveratrol can significantly inhibit the proliferation, invasion, and migration and promote the apoptosis of human ocular pathological scar fibroblasts and skin-derived pathological scar fibroblasts. [ABSTRACT FROM AUTHOR]

In this article, various convolutional neural network (CNN) architectures for the detection of pterygium in the anterior segment of the eye are explored and compared. Five CNN architectures (ResNet101, ResNext101, Se-ResNext50, ResNext50, and MobileNet V2) are evaluated with the objective of identifying one that surpasses the precision and diagnostic efficacy of the current existing solutions. The results show that the Se-ResNext50 architecture offers the best overall performance in terms of precision, recall, and accuracy, with values of 93%, 92%, and 92%, respectively, for these metrics. These results demonstrate its potential to enhance diagnostic tools in ophthalmology. [ABSTRACT FROM AUTHOR]

Background: Pterygium is atriangular fibroelastic degeneration of the conjunctiva and subconjunctival tissue. Methods: quasi experimental study, comprising 52 patients aged from 35 to 60 during perid from April 2021 to April 2022 who underwent pterygium excision and autologus conjunctival graft. A total of 52 participants were enrolled and followed before and after 1 and 3 months after surgery by pentacam Scheimpflug camera . Results: there were significant changs in keratometric astigmatism at 1 month and 3 months compared with preoperative mean keratometric astigmatism, and there were statistically significant reduction in mean refractive astigmatism at 1 month and3 months postoperatively compared with preoperative mean refractive astigmatism. Also, a significant increase of spherical power of the cornea, there were statistically significant increase in average K1 at 1 month 3 months postoperatively compared with preoperative average K, There were statistically significant increase in average K 2 after 1 month,3 months, postoperatively compared with preoperative average K2, The mean BCVA was 0.31(0.13 SD) equivalent Decimal value preoperatively and improved significantly at 1 month postoperatively 0.48 (0.13 SD) equivalent Decimal value, P <0.001) and 3 months postoperatively 0.60( 0.13 SD), P <0.001) when compared with preoperative values. Conclusions: pterygium excision was associated with significant improvement in astigmatism. [ABSTRACT FROM AUTHOR]

Introduction and purpose: We report a case of extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) scleritis after pterygium surgery. Methods: Case report. Results: A 58-year-old farmer presented with a 40-day history of severe pain, swelling, and blurred vision after a pterygium excision was performed at another institute. The patient was on multiple medications with no relief. The examination showed a nasally located scleral thinning in his right eye, with ulceration and infiltrates. Microbiology revealed Pseudomonas aeruginosa, which showed intermediate sensitivity to colistin only. The patient was administered topical (0.19%) and intravenous colistin and dexamethasone. There was a rapid reduction in symptoms, and the lesions healed over the next 2 months. Conclusions: To the best of our knowledge, this is the first case report of XDR-PA scleritis. We suggest the possibility of evolving drug resistance caused by the iatrogenic use of antibiotics during the early stages of the disease course. [ABSTRACT FROM AUTHOR]

Background/Aim: In current literature, there is a notable lack of studies investigating the role of radiationsensitive protein 51 (RAD-51) in pterygium diagnosis. Nevertheless, reports indicate elevated expression levels of RAD-51 among recurrent pterygium cases compared to those with primary pterygium. However, the genomic involvement of RAD-51 has yet to be explored in any population. This study aimed to assess the contribution of RAD-51 genotypes to pterygium risk in a representative Taiwanese population. Materials and Methods: RAD-51 rs1801320 genotyping was successfully conducted in a Taiwanese cohort comprising 140 pterygium cases and 280 non-pterygium controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Results: The distribution of RAD-51 rs1801320 genotypes (GG, CG, and CC) in the pterygium group (70.0%, 25.7%, and 4.3%, respectively) did not significantly differ from that in the nonpterygium group (73.6%, 23.6%, and 2.8% for GG, CG, and CC genotypes, respectively; p for trend=0.6337). Carriers of the variant CG and CC RAD-51 rs1801320 genotypes exhibited 1.15- and 1.58-fold increased pterygium risk, respectively (95%CI=0.72-1.84 and 0.53-4.67, p=0.6552 and p=0.5914, respectively). In the dominant model, there appeared to be a slight association between variant genotypes CG and CC and pterygium risk (OR=1.19, 95%CI=0.76-1.87, p=0.0223). Allelic analysis revealed that the RAD-51 rs1801320 variant C allele was not significantly linked to pterygium risk (17.1% versus 14.6%, OR=1.20, 95%CI=0.82-1.78, p=0.3991). Conclusion: Variant genotypes at RAD-51 rs1801320 were firstly identified to associate with susceptibility to pterygium among Taiwanese individuals. Nonetheless, these findings warrant validation in larger and more diverse populations. [ABSTRACT FROM AUTHOR]

Abstract The protein epidermal growth factor (EGF), which plays a crucial role in promoting cell proliferation and survival, has recently demonstrated potential in reducing inflammation. In this study, we examined the impact of EGF on the anti-inflammatory and anti-proliferative properties of pterygium, a prevalent hypervascular proliferative disease affecting the ocular surface. In surgically excised tissues, markers for fibrotic and inflammatory signals, including VIM, ACTA2, FAP, MMP2, VCAM1, ICAM1, CD86, IL6, and IL1B were upregulated in the pterygium body stroma compared to the normal conjunctival stroma. EGF exerted anti-inflammatory and anti-vasculogenic effects on pterygial fibroblasts when co-cultured with M1 macrophages. Moreover, exosomes derived from EGF-preconditioned M1 macrophages suppressed the heightened inflammatory and vasculogenic signals in pterygial fibroblasts induced by exosomes from M1 macrophages. Paradoxically, the proliferation of pterygial fibroblasts was inhibited by EGF in the in vitro microenvironment with M1 macrophages, despite EGF being known as a growth factor. EGF-preconditioning of M1 macrophages rescued the increased proliferation of pterygial fibroblasts induced by exosomes from M1 macrophages. In conclusion, our findings demonstrate that EGF effectively mitigates inflammation and proliferation in pterygial fibroblasts within a microenvironment containing M1 macrophages.

AIM: To detect the expression of P53 and mTOR in pterygium tissues and healthy conjunctival tissues, and to explore the relationship between the expression of P53 and mTOR, and the relationship between the expression of P53 and mTOR and the important clinical features of pterygium.METHODS: The surgical specimens of 43 patients(43 eyes)who underwent pterygium excision and autologous conjunctival transplantation in the First Affiliated Hospital of Shihezi University from November 2022 to May 2023 were collected. Healthy conjunctiva group was selected from the healthy conjunctival tissue that originated from the temporal conjunctiva of 13 patients. Totally 10 pterygium specimens and 6 normal conjunctival specimens were selected and the qPCR was used to detect the mRNA expression levels of P53 and mTOR in pterygium and normal conjunctival tissues. Another 33 cases of pterygium and 7 cases of normal conjunctival tissues were collected and the expression of P53 and mTOR in pterygium and normal conjunctival tissues were detected by immunohistochemistry. IPP6.0 software was used to calculate the average optical density, the correlation between the expression levels of P53 and mTOR, and the correlation between the expression levels of P53 and mTOR and the important clinical features of pterygium were analyzed.RESULTS: According to qPCR results, the mRNA expression levels of TP53 and mTOR in the pterygium group were significantly higher than those in the healthy conjunctiva group(all P 3 h was higher than that in the group of outdoor activity time ≤3 h(P 2 mm was higher than that in the group of pterygium head invasive limbal distance ≤2 mm(P 40 years and ≤40 years(P>0.05). There was no significant difference in the expression of mTOR between the groups of outdoor activity time > 3 h and ≤3 h, the group of pterygium head invasion distance > 2 mm and ≤2 mm, and the group of > 40 years old and ≤40 years old(all P>0.05). The expression of P53 was positively correlated with the duration of outdoor activities(r=0.484, P0.05).CONCLUSION: The overexpression of P53 and mTOR in pterygium showed a positive correlation, suggesting that the abnormal expression of P53 and mTOR may play a role in the pathogenesis of pterygium, which provides an experimental basis for further exploring the pathogenesis of pterygium; the expression of P53 is positively correlated with the time of outdoor activities and the distance of pterygium invasion. The P53 plays a role in evaluating the severity of pterygium, and provides new ideas for the clinical diagnosis and treatment of pterygium.

Abstract This study aims to estimate the familial risks of pterygium and assess its relative contributions to environmental and genetic factors using the 2000–2017 Taiwan National Health Insurance Research Database. The marginal Cox's model and the polygenic liability model were made. In Taiwan, the prevalence rate of pterygium in 2017 was 1.64% for individuals with affected first-degree relatives, higher than the general population (1.34%). The adjusted relative risk (RR) for pterygium was highest for twins of the same sex (15.54), followed by siblings of the same sex (4.69), offsprings (3.39), siblings of the different sex (2.88), spouse (2.12), parents (1.86), twins of the different sex (1.57), respectively. The phenotypic variance of pterygium was 21.6% from additive genetic variance, 24.3% from common environmental factors shared by family members, and 54.1% from non-shared environmental factors, respectively. Sensitivity analysis by restricting those with surgical pterygium reveals that aRRs and the three components were similar to those of the overall pterygium. In summary, the prevalence rate of pterygium was higher for individuals with affected first-degree relatives than for the general population. The non-shared environmental factors account for half of the phenotypic variance of pterygium; genetic and shared environmental factors explain the rest.

AIM: To investigate the impact of hsa_circ_0007482 on the proliferation and apoptosis of human pterygium fibroblasts (HPFs) and its correlation with the severity grades of pterygium. METHODS: Pterygium and normal conjunctival tissues were collected from the superior area of the same patient's eye (n=33). The correlation between pterygium severity and hsa_circ_0007482 expression using quantitative reverse-transcription polymerase chain reaction (RT-qPCR) were analyzed. Three distinct siRNA sequences targeting hsa_circ_0007482, along with a negative control sequence, were transfected into HPFs. Cell proliferation was assessed using the cell counting kit-8. Expression levels of Ki67, proliferating cell nuclear antigen (PCNA), Cyclin D1, Bax, B-cell lymphoma-2 (Bcl-2), and Caspase-3 were measured via RT-qPCR. Immunofluorescence staining was employed to detect Ki67 and vimentin expressions. Apoptosis was evaluated using flow cytometry. RESULTS: Hsa_circ_0007482 expression was significantly higher in pterygium tissues compared to normal conjunctival tissues (P

AIM:To observe the clinical efficacy of 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops in the treatment of dry eyes after pterygium surgery with lacrimal insufficiency.METHODS: A total of 64 cases(64 eyes)of pterygium patients with lacrimal insufficiency were treated with pterygium resection combined with limbal stem cell transplantation, and they were given routine anti-inflammatory and infection prevention treatment postoperatively. In terms of postoperative dry eye treatment, all patients were randomly divided into two groups. The observation group was treated with 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops, and the control group was treated with sodium hyaluronate eye drops. The break-up time of tear film(BUT), fluorescein(FL), Schirmer's Ⅰ test(SⅠt), ocular surface disease index(OSDI)score, central corneal thickness(CCT)changes, adverse reactions and complications were observed and compared between the two groups at different times postoperatively.RESULTS: Both groups of pterygium patients were accompanied with mild to moderate dry eyes with insufficient tear secretion preoperatively. At 2 wk after operation, both groups showed shorter BUT and higher FL score compared with those preoperatively(P0.05). At 4 wk after operation, BUT in the observation group was prolonged, OSDI score was decreased(both P0.05).CONCLUSION: In the treatment of dry eye after pterygium surgery with lacrimal insufficiency, 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops can effectively reduce the postoperative dry eye symptoms, and its clinical effect is better than that of sodium hyaluronate eye drops alone.

AIM: To evaluate the application of an intelligent diagnostic model for pterygium. METHODS: For intelligent diagnosis of pterygium, the attention mechanisms—SENet, ECANet, CBAM, and Self-Attention—were fused with the lightweight MobileNetV2 model structure to construct a tri-classification model. The study used 1220 images of three types of anterior ocular segments of the pterygium provided by the Eye Hospital of Nanjing Medical University. Conventional classification models—VGG16, ResNet50, MobileNetV2, and EfficientNetB7—were trained on the same dataset for comparison. To evaluate model performance in terms of accuracy, Kappa value, test time, sensitivity, specificity, the area under curve (AUC), and visual heat map, 470 test images of the anterior segment of the pterygium were used. RESULTS: The accuracy of the MobileNetV2+Self-Attention model with 281 MB in model size was 92.77%, and the Kappa value of the model was 88.92%. The testing time using the model was 9ms/image in the server and 138ms/image in the local computer. The sensitivity, specificity, and AUC for the diagnosis of pterygium using normal anterior segment images were 99.47%, 100%, and 100%, respectively; using anterior segment images in the observation period were 88.30%, 95.32%, and 96.70%, respectively; and using the anterior segment images in the surgery period were 88.18%, 94.44%, and 97.30%, respectively. CONCLUSION: The developed model is lightweight and can be used not only for detection but also for assessing the severity of pterygium.

Abstract Objective To estimate the pterygium ocular surface state, and compare with healthy eyes and dry eyes. To investigate the inflammation due to pterygia growth by tear Lymphotoxin-alpha (LT α) test. Design Prospective, single-center study. Participants 400 patients, divided into 100 pterygium group, 100 mild dry eye group, 100 moderate dry eye group, and 100 age-and sex-matched normal controls. Methods The non-invasive break-up time (NIBUT), tear meniscus height (TMH) test, corneal fluorescein staining (CFS), meibomian gland loss score (MGs), and lipid layer thickness (LLT) were evaluated in all patients. Pterygium status and ocular status in the pterygium group were collected. The tear LT α test was conducted in the pterygium patients group. Result Pterygium can affect the ocular surface, leading to decreased tear film stability. The TMH, NIBUT, CFS, MGs, and lipid layer thickness can provide insights into this phenomenon. The presence of pterygium can change the structure and condition of the ocular surface. Tear LT α testing shows an abnormal decrease in LT α levels in pterygium patients. This indicates an immune-inflammation microenvironment that causes tissue repair deficiency. Conclusion The dry eye triggered by the growth of pterygium may originate from the tear film instability due to pterygia. As an inflammatory index, LT α in the development of pterygium and the aggravation of dry eye patients can indicate that the ocular surface is in different inflammatory states. Future tear testing in LT α may be a potential indicator to assess the inflammatory status of the dry eye.

Background/Objectives: The main purpose of this study is to determine, by anterior segment optical coherence tomography (AS-OCT), the anatomical characteristics, both preoperatively and postoperatively, that correlate with a higher rate of pterygium recurrence after surgery with exeresis and conjunctival autograft with biological glue. Methods: A total of 50 eyes which were listed for primary pterygium surgery at an ophthalmology tertiary centre were treated with standard pterygium excision and a conjunctival autograft with tissue glue. Ten variables were measured with AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan) during six control visits with all patients. Finally, statistical analysis was performed using SPSS (SPSS stadistics®, IBM®, version 21.0.0.0) for descriptive variables and R-project (The R foundation©, version 3.0.2) for the rest of the analyses, including a descriptive analysis and an inferential analysis studying prognostic factors of recurrence and their predictive capacity. Results: Among the 50 patients who underwent surgery, recurrence was detected in 8 cases (rate 16%; 95% CI: 5.8–26.2%). Most cases (n = 6) were detected 3 months after surgery. The pattern of recurrences was atrophic in two thirds of the cases; none required reintervention. Preoperative total conjunctival thickness at 3 mm was significantly increased in patients who developed recurrence. One week after surgery, epithelial and stromal thickness at 1 mm and total thickness at 3 mm proved to be useful for predicting recurrence. Both models have significant discriminant capacity. Conclusions: By imaging the graft with AS-OCT preoperatively and 7 days after surgery, the risk of future recurrence can be predicted. [ABSTRACT FROM AUTHOR]

Pterygium is often associated with chronic ultraviolet (UV) radiation exposure and characterized by the overgrowth of conjunctiva and extracellular matrix (ECM) remodeling. Notably, several studies in the skin have demonstrated that chronic UV radiation can upregulate Granzyme B (GrB) expression and increase ECM degradation. The aim of this study was to compare GrB expression between pterygium and healthy controls and to further link this GrB expression to mast cells. Post-mortem pterygium tissues and conjunctival tissues from age-matched controls were used to assess GrB expression via immunofluorescence and microscopy. We found a significantly higher density of GrB+ cells from pterygium specimens compared to healthy controls. Furthermore, many of the GrB+ cells in pterygium specimens co-expressed tryptase, a mast cell marker. These findings suggest a role for conjunctival mast cell-secreted GrB in the pathogenesis of pterygium and highlight GrB as a possible therapeutic target in delaying or halting pterygium progression. [ABSTRACT FROM AUTHOR]

This study aims to estimate the familial risks of pterygium and assess its relative contributions to environmental and genetic factors using the 2000–2017 Taiwan National Health Insurance Research Database. The marginal Cox's model and the polygenic liability model were made. In Taiwan, the prevalence rate of pterygium in 2017 was 1.64% for individuals with affected first-degree relatives, higher than the general population (1.34%). The adjusted relative risk (RR) for pterygium was highest for twins of the same sex (15.54), followed by siblings of the same sex (4.69), offsprings (3.39), siblings of the different sex (2.88), spouse (2.12), parents (1.86), twins of the different sex (1.57), respectively. The phenotypic variance of pterygium was 21.6% from additive genetic variance, 24.3% from common environmental factors shared by family members, and 54.1% from non-shared environmental factors, respectively. Sensitivity analysis by restricting those with surgical pterygium reveals that aRRs and the three components were similar to those of the overall pterygium. In summary, the prevalence rate of pterygium was higher for individuals with affected first-degree relatives than for the general population. The non-shared environmental factors account for half of the phenotypic variance of pterygium; genetic and shared environmental factors explain the rest. [ABSTRACT FROM AUTHOR]

Pterygium is a wing-shaped fibrovascular growth extending from the conjunctiva onto the cornea. This review aims to provide a comprehensive overview of pterygium, including its etiology, clinical presentation, diagnosis, treatment options, and prognosis. A literature search was conducted using PubMed and Google Scholar databases. Findings suggest that pterygium is primarily associated with UV exposure and occurs more frequently in tropical and subtropical regions. Diagnosis is primarily clinical, with treatment options ranging from conservative management to surgical intervention. While generally benign, pterygium can cause visual disturbances and has a significant recurrence rate post-surgery. [ABSTRACT FROM AUTHOR]

This article introduces an innovative mobile solution for Pterygium detection, an eye disease, using a classification model based on the convolutional neural network (CNN) architecture ResNext50 in images of the anterior segment of the eye. Four models (ResNext50, ResNet50, MobileNet v2, and DenseNet201) were used for the analysis, with ResNext50 standing out for its high accuracy and diagnostic efficiency. The research, focused on applications for ophthalmological medical centers in Lima, Peru, explains the process of development and integration of the ResNext50 model into a mobile application. The results indicate the high effectiveness of the system, highlighting its high precision, recall, and specificity, which exceed 85%, thus showing its potential as an advanced diagnostic tool in ophthalmology. This system represents a significant tool in ophthalmology, especially for areas with limited access to specialists, offering a rapid and reliable diagnosis of Pterygium. The study also addresses the technical challenges and clinical implications of implementing this technology in a real-world context. [ABSTRACT FROM AUTHOR]

Background/aim: To compare the efficacy of topical 0.05% cyclosporine A (CsA) and 0.1% topical cyclosporine A (CsA) over a 6-month period following pterygium surgery, specifically evaluating their effects on postoperative recurrence and clinical parameters. Material and methods: This clinical study enrolled 245 patients with pterygium who underwent surgery using the conjunctival autograft technique with mitomycin C (MMC) were enrolled. Participants were divided into three groups: Group 1 (0.05% CsA) (n = 80), Group 2 (0.1% CsA) (n = 80), and a control group (n = 85). They were examined at postoperative first day, first week, first month and sixth month. The examination included best corrected visual acuity (BCVA), intraocular pressure (IOP), presence of inflammation, and ptergium recurrence, all of which were compared across the groups. Results: The mean age of the patients was 63.22 ± 9.39 years, with 53.3% male and 46.7% female. The three groups were similar in terms of demographic characteristics and pterygium size. Inflammation in surgical area significantly regressed in all groups at 6 months postoperatively (p < 0.05). Inflammation in the first and sixth months was not different between the groups (p = 0.118, p = 0.580, and p = 0.435, respectively). The recurrence rate was not different between groups (p = 0.890). There was no statistically significant difference between groups regarding IOP (p = 0.818). A significant increase in BCVA after surgery was observed in three groups compared to preoperative levels (p < 0.05). Conclusion: This study showed that there was no difference between the efficacy of 6 month topical 0.05% CsA and 0.1% CsA application after pterygium surgery with the conjunctival autograft technique with MMC on postoperative outcomes. Including postoperative recurrence, IOP changes, BCVA changes and surgical area inflammation. [ABSTRACT FROM AUTHOR]

Pterygium is a frequent eye surface condition that is characterized by a high rate of proliferation, fibrovascular development, cellular migration, corneal infiltration, and angiogenesis. We investigated that ex vivo primary pterygium and conjunctival cell cultures were generated to analyze the effect of trehalose on cellular proliferation. After trehalose treatment, we performed microarray analysis to evaluate changes in the mRNA profile. We analyzed gene ontology (GO) and KEGG pathways to identify hub genes that changed expression levels after treatment and were associated with pterygium development. We selected three genes to verify their expression levels using qRT–PCR. The study also evaluated the impact of trehalose treatment on cell migration through a wound‐healing assay. Our results suggested that pterygium cell proliferation was inhibited in a dose‐dependent manner by trehalose. 2354 DEG were identified in pterygium and conjunctiva cells treated with trehalose compared to untreated groups. Functional enrichment analysis showed that differentially expressed mRNAs are involved in proliferation, vasculature development, and cell migration. We identified ten hub genes including upregulated (RANBP3L, SLC5A3, RERG, ANKRD1, DHCR7, RAB27B, GPRC5B, MSMO1, ASPN, DRAM1) and downregulated (TNC, PTGS2, GREM2, NPTX1, NR4A1, HMOX1, CXCL12, IL6, MYH2, TXNIP). Microarray analysis and functional investigations suggest that trehalose affects the pathogenesis of pterygium by modifying the expression of genes involved in crucial pathways related to cell function. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Pterygium is a common ocular surface disorder characterized by a fibrovascular growth extending onto the cornea, often leading to visual impairment through induced astigmatism and corneal distortion. Surgical excision is the primary treatment, with Amniotic Membrane Grafts (AMG) and Conjunctival Autografts (CAG) being the prevalent techniques. This study aims to compare the autorefractive changes post-pterygium excision using AMG versus CAG. MATERIALS AND METHODS: This prospective comparative study included 25 eyes from 25 patients with nasal pterygium, who underwent excision surgery at the Sree Mookambika Institute of Medical Sciences between July 2022 and December 2023. Patients were divided into two groups: 13 underwent AMG and 12 underwent CAG. Preoperative and postoperative assessments included Best Corrected Visual Acuity (BCVA), autorefractometry, pachymetry, and anterior segment examination. Statistical analysis was performed using the Student t-test, with significance set at p < 0.05. RESULTS: Both AMG and CAG groups showed significant reductions in astigmatism postoperatively, though differences between the two techniques were not statistically significant (AMG: p = 0.34; CAG: p = 0.28). Vision improved significantly from a mean BCVA of 0.47 ± 0.36 to 0.68 ± 0.25 (p = 0.01), and central corneal thickness increased from 516.16 ± 38.03 µm to 533.44 ± 34.32 µm (p = 0.02). The recurrence rate was lower in the CAG group (5.3%) compared to the AMG group (10.5%). CONCLUSION: Both AMG and CAG techniques effectively reduce postoperative astigmatism and improve visual outcomes following pterygium excision. Despite similar refractive outcomes, CAG may offer advantages in terms of recurrence rates. Further research with larger sample sizes and longer follow-up periods is warranted to delineate the long-term benefits of each technique. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been reported that the application of biotic amniotic membrane and corneal bandage lens in pterygium surgery can significantly reduce the pain reaction after pterygium excision and promote the healing of corneal wounds. OBJECTIVE: To compare the efficacy of biotic amniotic membrane and corneal bandage lens on the repair of corneal wounds and neuropathic pain after pterygium surgery. METHODS: A total of 121 cases (142 eyes) of primary pterygium patients admitted to Nanyang Second People’s Hospital from August 2020 to May 2022 were retrospectively selected. They all underwent pterygium excision combined with autogenous free conjunctival flap transplantation. Among them, 63 cases (68 eyes) of pterygium postoperative wound repair with biotic amniotic membrane were classified as the amniotic membrane group, and 58 cases (74 eyes) of pterygium wound repair with corneal bandage lens were classified as the bandage lens group. Postoperative follow-up was conducted, and the corneal wound repair of the patients within 2 weeks after surgery was recorded. Neuropathic pain was quantified by Wong-Baker face on the day after surgery, 1 day, and 2 weeks after surgery. The corneal topographic map indicating asymmetry index, best corrected visual acuity, corneal refractive index, and surface rule index were recorded before surgery, 1 and 3 months after surgery. RESULTS AND CONCLUSION: (1) 2 weeks after treatment, the wound repair rate in the bandage lens group was significantly higher than that in the amniotic membrane group (P < 0.05). The wound healing time was shorter in the bandage lens group than that in the amniotic membrane group (P < 0.01). (2) The degree of neuropathic pain in the bandage lens group was lower than that in the amniotic membrane group on the day and 1 day after surgery (P < 0.001), and there was no significant difference between the two groups in neuropathic pain at 2 weeks after surgery (P > 0.05). (3) The corneal topographic map indicating asymmetry index, best corrected visual acuity, corneal refractive index, and surface rule index were significantly improved in both groups 1 and 3 months after surgery (P < 0.05). The corneal topographic map indicating asymmetry index, corneal refractive index, and surface rule index of the bandage lens group were lower than those of the amniotic membrane group 1 and 3 months after surgery (P < 0.05). (4) Recurrence occurred in 1 eye (1.47%) in the amniotic membrane group and 3 eyes (4.05%) in the bandage lens group within 3 months after operation, and there was no significant difference between the groups (P > 0.05). (5) These findings suggest that the corneal bandage lens is more effective than the biotic amniotic membrane in the repair of corneal wounds after pterygium surgery. [ABSTRACT FROM AUTHOR]

Objective: To estimate the pterygium ocular surface state, and compare with healthy eyes and dry eyes. To investigate the inflammation due to pterygia growth by tear Lymphotoxin-alpha (LT α) test. Design: Prospective, single-center study. Participants: 400 patients, divided into 100 pterygium group, 100 mild dry eye group, 100 moderate dry eye group, and 100 age-and sex-matched normal controls. Methods: The non-invasive break-up time (NIBUT), tear meniscus height (TMH) test, corneal fluorescein staining (CFS), meibomian gland loss score (MGs), and lipid layer thickness (LLT) were evaluated in all patients. Pterygium status and ocular status in the pterygium group were collected. The tear LT α test was conducted in the pterygium patients group. Result: Pterygium can affect the ocular surface, leading to decreased tear film stability. The TMH, NIBUT, CFS, MGs, and lipid layer thickness can provide insights into this phenomenon. The presence of pterygium can change the structure and condition of the ocular surface. Tear LT α testing shows an abnormal decrease in LT α levels in pterygium patients. This indicates an immune-inflammation microenvironment that causes tissue repair deficiency. Conclusion: The dry eye triggered by the growth of pterygium may originate from the tear film instability due to pterygia. As an inflammatory index, LT α in the development of pterygium and the aggravation of dry eye patients can indicate that the ocular surface is in different inflammatory states. Future tear testing in LT α may be a potential indicator to assess the inflammatory status of the dry eye. [ABSTRACT FROM AUTHOR]

Objective • Pterygium and conjunctival laxity are common ocular conditions that can significantly affect visual comfort and quality of life. Therefore, it is essential to investigate ways to treat these problems. This study aimed to compare the effectiveness of same-stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery versus staged pterygium excision, crescentic conjunctiva excision, and scleral fixation surgery in treating pterygium combined with conjunctival laxity. The study also aimed to evaluate the impact of these surgical techniques on postoperative complications. Methods • From June 2019 to May 2021, 90 patients (90 eyes) with pterygium combined with conjunctival laxity were included in this study and were randomly divided into two groups (A and B) using a simple number table method. Group A underwent same- stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery, while group B underwent staged pterygium excision, crescentic conjunctiva excision, and scleral fixation surgery. The International Ocular Surface Disease Index (OSDI), degree of conjunctival laxity excision, changes in ocular tear film dynamics, recurrence rate, and postoperative complications were compared between the two groups. Results • The results showed that different surgical methods for pterygium and conjunctivochalasis did not significantly improve the symptoms and quality of life of patients. This suggests that more intensive research is needed to find more effective treatments. Therefore, the risks and benefits should be carefully considered when selecting ophthalmologic surgery, OSDI scores and fluorescein staining results of both groups were trending downward after surgery, while the breakup time of the tear film and height of the tear meniscus was increasing but there was no significant difference in the above indicators (P > .05). However, there was no significant difference in the above indicators between the two groups before surgery, at 1, 3, and 6 months, and at 1 year after surgery (P > .05). There was also no significant difference in the degree of conjunctival laxity excision between the two groups at 1 and 3 months after surgery (P > .05). Finally, there was no significant difference in the healing time of the conjunctiva and recurrence rates between the two groups (P > .05). The results showed that different surgical methods for pterygium and conjunctivochalasis did not significantly improve the symptoms and quality of life of patients. This suggests that more intensive research is needed to find more effective treatments. Therefore, the risks and benefits should be carefully considered when selecting ophthalmologic surgery. Conclusion • The results of this study showed no significant differences between surgical techniques, making monitoring and management of complications after surgery even more critical. Patients need to be carefully watched for possible complications such as infection, discomfort, and inflammation. Doctors and medical teams should be alert in advance and take appropriate measures to deal with these problems in a timely manner to ensure the success of the operation and the comfort of the patient. By monitoring and proactively managing potential complications, unnecessary pain and complexity can be reduced, thereby improving patient experience and outcomes. Additionally, the study had several limitations, including a small sample size, a limited study period, and failure to consider other potential factors. These limitations need to be addressed in future studies to validate and extend the results of this study. In conclusion, same-stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery is an effective treatment for patients with pterygium combined with conjunctival laxity, which can improve their visual function and ocular tear film dynamics. However, careful monitoring and management of postoperative complications are necessary. [ABSTRACT FROM AUTHOR]

Background Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented malignancy of the ocular surface and is represents with a wide morphological types and clinical symptoms. Along with that it has wide range of histologic diagnoses, ranging from mild epithelial dysplasia to invasive squamous carcinoma. The diagnosis rely on histopathological examination of the excised mass and imaging to rule out infiltration. Aim The aim to study the demographics, presenting features, different morphological types, histopathological types and associated risk factors of ocular surface squamous neoplasia (OSSN). Methods This was a prospective case study of 27 cases with conjunctival masses suspicious of OSSN presenting to our centre between November 2022 and October 2023. Results Among 27 cases 17 (62.96%) males and 10 (37.03%) females, with a mean age of 54.3 years (range 22-68 years). The main presenting symptoms were a mass or growth on the eye, followed by eye irritation or pain, pigmentation and visual impairment. The associated risk factors included chronic sun exposure, smoking and tobacco usage, HIV serology positive, and Ocular trauma. The lesions were most common near the limbus, most commonly seen in the interpalpebral area, nasal quadrant. Among the lesions 59.25% had less than 3 clock hours of limbal involvement. The most common presenting clinical morphological feature of the tumor was a leukoplakic lesion, followed by papilliform, nodular, gelatinous, pigmented and mixed morphology accordingly. Vascularization, hyperpigmentation and pterygium was the most common association. Conjunctival or corneal intraepithelial neoplasm (17) was most common in comparison with squamous cell carcinoma (10) Conclusion OSSN in our study mainly presented with leukoplakic variant, most commonly involving limbus with a feeder vessel. Most common in males. HIV serology was positive in younger patients. Larger lesion, papilliform variant most commonly showed squamous cell neoplasia in histology. [ABSTRACT FROM AUTHOR]

Purpose: To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation. Methods: PubMed and Scopus were the main resources used to search the medical literature. An extensive search was performed to identify relevant articles concerning factors influencing the level of corneal aberrations as of August 27, 2023. The following keywords were used in various combinations: corneal, aberrations, defocus, astigmatism, spherical aberration, coma, trefoil, quadrafoil, intraocular lens, and IOL. Results: Conclusive evidence is lacking regarding the correlation between age and changes in corneal aberrations. Patients with astigmatism have greater corneal higher-order aberrations than those with minimal astigmatism, particularly concerning trefoil and coma. Increased levels of corneal higher-order aberrations are noted following contact lens wear, in patients with dry eye disease, and with pterygium. Increased higher-order aberrations have been reported following corneal refractive surgery and for 3 months following trabeculectomy; regarding intraocular lens surgery, the results remain controversial. Conclusions: Several factors influence the level of corneal higher-order aberrations. Multifocal and extended depth-of-focus IOLs can share similarities in their optical properties, and the main difference arises in their design and performance with respect to spherical aberration. Preoperative evaluation is critical for proper IOL choice, particularly in corneas with risk of high levels of aberrations. [J Refract Surg. 2024;40(6):e420–e434.] [ABSTRACT FROM AUTHOR]

A 40-year-old woman visited our clinic for recurred pterygium and symblepharon in the right eye. She had a history of pterygium excision 8 years before. Over the course of 7 years, we performed pterygium excision combined initially with mitomycin C (MMC) application and conjunctival autograft. This was followed by three procedures using limbal allografts, MMC application, and amniotic membrane transplantation. All procedures were unsuccessful, resulting in aggressive recurrences of pterygial mass and symblepharon, extraocular movement limitation, corneal astigmatism, and decreased visual acuity. Ultimately, we applied a labial mucosal autograft after the recession of pterygial tissue. No complications were observed. Two and a half years postoperatively, the labial mucosal autograft was well-integrated into the conjunctival surface without symblepharon recurrence or abduction limitation. Corneal clarity was restored, and astigmatism was reduced, with no recurrence of pterygium. In conclusion, a labial mucosal autograft is a viable treatment option in complex cases of recalcitrantly recurrent pterygium with symblepharon.

ABSTRACT This report described a case of a 56-year-old female patient with a history of pterygium excision and use of mitomycin C eye drops during the postoperative period who developed necrotizing infectious scleritis caused by Pseudomonas aeruginosa. The patient was admitted for treatment with intravenous antibiotic therapy, topical fortified antibiotics, systemic corticotherapy, and debridement of the necrotic ocular tissue. After 3 weeks, she presented with good clinical evolution and resolution of the infection. Mitomycin eye drops should be used cautiously, particularly after surgery. If mitomycin is used, it should be applied at the lowest concentration and for the shortest duration possible and should be avoided postoperatively to prevent these complications. Although scleral infection is a serious condition with a high risk of permanent vision loss, early and appropriate treatment can be critical for good clinical outcomes.

There has been an increased understanding of the protective effect of two or more hours in high lux light on the development and progression of myopia. The aim of myopia management is to reduce the incidence of high myopia and sight-threatening myopic complications. Equally important are the sight-threatening complications of ultraviolet radiation (UVR) on the eye and adnexal structures. This review will analyze the literature for both these epidemics to help guide public health policy. Whilst increasing childhood high lux light exposure is important, consideration of a holistic eye health policy should ensure that UV eye diseases are also prevented. The advent of ultraviolet (UV) fluorescence photography has increased our understanding that significant UV eye damage occurs in childhood, with 81% of children aged 12–15 years having signs of UV eye damage. Hence, the need to reduce myopia and protect from UV-related eye diseases needs simultaneous consideration. Advocating for eye protection is important, particularly as the natural squint reflex is disabled with dark sunglasses lenses. The pathways UV reaches the eye need to be considered and addressed to ensure that sunglasses offer optimum UV eye protection. The design of protective sunglasses that simultaneously allow high lux light exposure and protect from UVR is critical in combating both these epidemics.

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

OBJECTIVES: The aim of this study was to retrospectively evaluate the signalment, treatment, surgical technique and outcomes for feline symblepharon. METHODS: A retrospective medical record review and standardized grading of clinical descriptions and photographs was undertaken. RESULTS: Forty kittens (54 eyes) aged 3-46 weeks had symblepharon of five types in various combinations: eyelid deformation (24 kittens; 32 eyes); ankyloblepharon (four kittens; four eyes); conjunctiva-to-conjunctiva (11 kittens; 12 eyes); third eyelid-to-conjunctiva (24 kittens; 29 eyes); and corneoconjunctival adhesions (14 kittens; 16 eyes). At initial presentation, 23 (43%) eyes were affected by one type of symblepharon, 25 (46%) eyes by two types and six (11%) eyes by three types; 11 (20%) corneas were ulcerated. Twenty-four (44%) eyes of 18 (45%) kittens were managed medically. Surgery was performed under general anesthesia/sedation (30 occasions) or topical anesthesia (21 occasions) on 30 (56%) eyes of 22 kittens; 12 eyes (40%) underwent multiple surgeries. Four techniques were commonly employed: separation of conjunctival-to-conjunctival adhesions ± eyelid margins (14 eyes); resection of third eyelid adhesions ± temporary tacking of the third eyelid (modified Arlts pterygium technique; 18 eyes); en bloc resection of the third eyelid (two eyes); and separation of corneoconjunctival adhesions (14 eyes). Median duration of follow-up was 55 days (range 1-1051). Median symblepharon grade in kittens treated surgically improved for all types except corneoconjunctival symblepharon. Median symblepharon grade in kittens receiving medical management remained the same or improved. Corneoconjunctival symblepharon opacity decreased for eyes treated surgically but increased for eyes treated medically. Three eyes were enucleated due to complications of corneoconjunctival symblepharon. At final presentation, symblepharon persisted in 46 (85%) eyes; however, menace response was evident in 13/16 eyes and dazzle reflex in 23/23 eyes. CONCLUSIONS AND RELEVANCE: Symblepharon is a heterogeneous group of conditions with diverse anatomic involvement, clinical appearance and impact, optimal treatment and prognosis for vision.

Introduction: Popliteal pterygium syndrome is a rare congenital disorder characterized by orofacial, cutaneous, musculoskeletal, and genital anomalies. The popliteal pterygium (PP) affects ambulation due to severe knee flexion contracture and equinovarus deformities. Surgical treatment aims to correct these deformities while preserving limb sensibility. However, due to its rarity, surgical guidelines are lacking. Materials and methods: A meta-analysis according to PRISMA guidelines was conducted to summarize and compare surgical methods for PP. 183 paper were identified in PubMed and data from 32 articles were analyzed, including patient demographics, treatment modalities (Ilizarov fixator, femoral osteotomy, skin/soft tissue procedures, hamstring release, nerve surgery, and amputation), pre- and post-operative abilities to walk, knee joint parameters, complications, and recurrent contractions. Results: Among 58 patients (87 limbs), Ilizarov fixator demonstrated improved knee and ankle mobility postoperatively, but showed a relatively high surgical session count and complication rates. Femoral osteotomy achieved successful knee posture correction with fewer sessions and no complications. Isolated skin/soft tissue procedures improved flexion contracture and mobility, though they required several procedures. Hamstring release achieved notable contracture reduction but also necessitated multiple interventions. Nerve surgery and amputation had limited data, warranting further investigation. Conclusion: The management of PP demands a comprehensive approach, considering individual patient characteristics and treatment outcomes. While different surgical modalities offer distinct benefits, a classification or guideline to treat this deformity is still lacking. Further research is essential to validate findings, refine treatment approaches, and enhance the quality of life for individuals with PP. [ABSTRACT FROM AUTHOR]

Purpose: To study the biomarkers present in primary pterygium samples of patients of Indian ethnicity and compare it with the samples obtained from the unaffected conjunctiva of the same eye. Methods: A prospective case-control study of 17 eyes in patients above 10 years of age with primary pterygium who underwent pterygium excision using limbal conjunctival autograft technique. The pterygium samples (cases) and conjunctival samples (controls) were sent for immunohistochemical (IHC) staining for the following biomarkers: p53, Bcl-2, Ki-67, and vascular endothelial growth factor (VEGF). Result: The immunohistochemistry of the samples and the controls revealed p53 positivity in 47.05% of pterygium samples and 29.4% of controls (P < 0.587). Nine cases each in pterygium and control samples were positive for Ki-67 expression. Differences in the staining pattern between the two groups were not statistically significant (P < 1.000). Bcl-2 positivity was seen in 10 pterygium samples (58.8%) and 12 controls (70.5%), with no statistical difference between the two groups (P < 0.455). VEGF expression was seen in both epithelial and endothelial cells of the samples and controls, with no statistical difference between the two groups, with P = 1.000 for the epithelial staining and P = 0.637 for endothelial staining. Conclusion: The expression of biomarkers was comparable in both groups. We conclude that pterygium, against common belief, might not be a localized disease process but a global ocular phenomenon where the apparently healthy tissue also has some ongoing disease process at a molecular level. [ABSTRACT FROM AUTHOR]

Purpose: Pterygium is a common ocular surface disease defined by fibrovascular conjunctival growth extending onto the cornea. However, its pathogenesis remains unclear. This study aimed to determine the role of CD44, proliferating cell nuclear antigen (PCNA), and E-cadherin in pterygium formation and recurrence. Methods: Sixty patients with pterygium participated in the study, and we collected conjunctival samples from 30 patients to form a control group. CD44, PCNA, and E-cadherin expressions in surgically excised pterygium were compared with tissue samples from the control group. Results: We observed that the percentages of CD44 and PCNA were statistically higher in the primary pterygium group and recurrent pterygium group than in the control group (P < 0.001 and P < 0.001, respectively). Conversely, E-cadherin values were statistically higher in the control group than in the primary and recurrent pterygium groups (P = 0.013 and P < 0.001, respectively). Conclusion: Cell proliferation and cell adhesion factors may play important roles in the pathogenesis of pterygium. [ABSTRACT FROM AUTHOR]

A pterygium is a common conjunctival degeneration and inflammatory condition. It grows onto the corneal surface or limbus, causing blurred vision and cosmetic issues. Ultraviolet is a well-known risk factor for the development of a pterygium, although its pathogenesis remains unclear, with only limited understanding of its hereditary basis. In this study, we collected RNA-seq from both pterygial tissues and conjunctival tissues (as controls) from six patients (a total of twelve biological samples) and retrieved publicly available data, including eight pterygium samples and eight controls. We investigated the intrinsic gene regulatory mechanisms closely linked to the inflammatory reactions of pterygiums and compared Asian (Korea) and the European (Germany) pterygiums using multiple analysis approaches from different perspectives. The increased expression of antioxidant genes in response to oxidative stress and DNA damage implies an association between these factors and pterygium development. Also, our comparative analysis revealed both similarities and differences between Asian and European pterygiums. The decrease in gene expressions involved in the three primary inflammatory signaling pathways—JAK/STAT, MAPK, and NF-kappa B signaling—suggests a connection between pathway dysfunction and pterygium development. We also observed relatively higher activity of autophagy and antioxidants in the Asian group, while the European group exhibited more pronounced stress responses against oxidative stress. These differences could potentially be necessitated by energy-associated pathways, specifically oxidative phosphorylation. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo report the clinical presentation, anterior segment optical coherence tomography features, treatment, and outcomes of ocular surface squamous neoplasia (OSSN) associated with pterygium.Retrospective interventional series of 14 cases in a 28-month study period.OSSN was coexistent with pterygium (n = 14) in < 1% of all pterygia (n = 7384). The mean age at the presentation of OSSN with pterygium was 49 years (median, 49 years; range, 36 to 71 years). Referral diagnosis included pterygium sans OSSN (n = 7, 50%), granuloma (n = 1, 7%), actinic keratosis (n = 1, 7%), and conjunctivitis (n = 1, 7%). All OSSNs were unilateral, and six patients (43%) had bilateral pterygia. Tumors arose from the nasal (n = 8, 57%), or temporal (n = 6, 43%) quadrants. The mean tumor diameter was 4 mm (median, 4 mm; range, 2 to 6 mm), and the mean thickness was 2 mm (median, 1 mm; range, 1 to 3 mm). The delineation between OSSN and pterygium could be identified on anterior segment optical coherence tomography (AS-OCT) in all (100%) cases. All patients received 1% topical 5-fluorouracil (5-FU), and complete tumor regression was achieved in 13 (93%) cases with a mean number of 2 cycles (median, two cycles; range, 1 to 4 cycles). There were no significant adverse effects. No tumor recurrence was noted over a mean follow-up period of 11 months (median 12 months; range, 1 to 4 months)AS-OCT allows accurate detection and mapping of tumor extent in OSSN with coexistent pterygium, and topical 5-FU yields excellent tumor control. [ABSTRACT FROM AUTHOR]