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AbstractPrimary fibroblasts isolated from pterygium and skin pathological scar were identified by immunofluorescence staining. It was found by CCK8 and TUNEL that high-dose resveratrol, a Chinese medicine monomer, could inhibit proliferation, promote apoptosis and restrain migration. Explored by whole-transcriptome sequencing and LC-MS/MS, 1531 up-regulated mRNAs, 1022 down-regulated mRNAs, 79 up-regulated proteins and 84 down-regulated proteins were identified in resveratrol-treated pterygium fibroblasts. It was shown by KEGG, GO, PPI and the following bioinformatics analysis that resveratrol may affect proliferation, apoptosis and migration of fibroblast through TGFB2/3 and COL1A1/2. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionPterygium is a common ocular surface disease characterized by a high recurrence rate and unknown etiology.In this study, we investigated the upregulation of matrix metalloproteinase genes, including MMP1, MMP2, MMP3, MMP7, MMP9, MMP11, MMP12, MMP13, MMP23B, and MMP28, in pterygium tissue using RNA sequencing, Western blotting, and immunohistochemistry.Employing the MEME tool, we identified a conserved DNA motif within the promoter regions of these matrix metalloproteinase genes. Mass spectrometry analysis revealed an interaction between the cohesin complex and this motif. Disrupting the cohesin complex through RNA interference of RAD21 cohesin complex component or structural maintenance of chromosomes 3 in primary pterygial fibroblasts led to decreased matrix metalloproteinase gene expression and reduced recruitment of twist family bHLH transcription factor 1 and transcription factor 4 to matrix metalloproteinase gene promoters.Overall, our findings suggest a novel epigenetic mechanism regulating matrix metalloproteinase transcription in pterygium. [ABSTRACT FROM AUTHOR]

Pterygium is an ocular disease in which the conjunctival tissue invades the cornea. When the pterygium tissue reaches the pupillary region, the visual function of the patient is affected. Currently, surgical removal is the only effective treatment. However, the recurrence rate of pterygium after surgery can be high. Pterygium is also a health disparity issue since it is more prevalent in the Hispanic and Latino American population. In this study, we determined if the Rho kinase inhibitor can be used to prevent pterygium recurrence since its anti-fibrosis effects have been reported in other cell and tissue types. We cultured primary pterygium cells from pterygium tissues from Hispanic and Latino American, African American, Caucasian, and Asian donors, and used those cells for viability assays, scratch assays, migration assays, and immunostaining of F-actin, fibronectin, collagen I and α smooth muscle actin. We found that the Rho kinase inhibitor Y27632 decreased cell viability, wound healing, cell migration, as well as the expression of extracellular matrix and myofibroblast markers in cultured pterygium cells. We believe that Rho kinase inhibitors are a potential post-surgical treatment to prevent pterygium recurrence. [ABSTRACT FROM AUTHOR]

INTRODUCTION Pterygium is a common disease of the ocular surface characterized by the invasion of fibrovascular tissue from the bulbar conjunctiva onto the cornea. It can cause chronic ocular irritation, tear film disturbances, induced astigmatism, and decreased vision secondary to growth over the visual axis. OBJECTIVES To assess precorneal Tear film before and after pterygium surgery. METHOD This prospective observational study was done on all consecutive patients with pterygium came to ophthalmology OPD at R L Jalappa hospital in kolar from August 2022 to December 2023. A total of 39 eyes were included in each group of which 12 were males and 27 females. All the patients subjected for detail visual acuity (VA) assessment, slit lamp examination, intraocular pressure (IOP) estimation, tear film function tests and underwent Pterygium excision with conjunctival limbal autograft. They were followed post-operatively 1 week, 4 weeks and 6weeks. RESULTS Majority of the patients were females (69.2%), while 30.8% were males with average age (in years) as 51.33 years. Majority had Type 2 (51.3%), followed by Type 3 (26.6%) and Type 1 (23.1%). Schimers test 1 was significantly decreased in the affected eye compared to control eye at pre-op and 1 week following post-op. There was no significant difference in the ST1 at 4 weeks and 6 weeks between the affected and control eyes. Schimers test 2 was significantly decreased in the affected eye compared to control eye at pre-op, one week and four weeks following post-op. There was no significant difference in the ST-2 at 6 weeks between the affected and control eyes. TBUT was significantly decreased in the affected eye compared to control eye at pre-op, and 4 weeks following post-op. There was no significant difference in the TBUT at 1 week and 6 weeks between the affected and control eyes. TMH was significantly lower in the affected eye than the control eye at pre-op, and 1 week following post-op. No significant difference in the TMH at 4 weeks and 6 weeks between the affected and control eyes was noticed. Comparision of schirmers test 1, schirmers 2, TBUT and TMH at 1week, 4 week & 6 weeks between preop and post op in type 1 pterygium, among the affected eye, the tear film function significantly improved. CONCLUSION Our research found that after the pterygium was removed, the measurements, such as Schirmers and Tear Break-up Time (TBUT), showed improvement over time. After a month after the operation in the affected eye, the Schirmers and Tear Break-up Time were almost as close to the control eye's values. This suggests that the dry eye symptoms related to the pterygium got better after the surgery. Nonetheless, our research did not include a long-term check-up to explore if the pterygium would come back and how it might affect the tear film's function. [ABSTRACT FROM AUTHOR]

The ocular safety of 222‐nm far‐ultraviolet‐C (UV‐C) irradiation, widely recognized for its germicidal properties, was evaluated in a clinical setting to assess its long‐term health effects on the human eye. This prospective observational study involved a 36‐month follow‐up of physicians working in an ophthalmic examination room equipped with 222‐nm UV‐C lamps. Initially, a 12‐month observation showed no signs of acute or chronic ocular damage. To further substantiate these findings, the study period was extended to 36 months, during which four participants underwent regular ocular examinations, including assessments of visual acuity, refractive error, and corneal endothelial cell density. The irradiation dose was meticulously controlled to remain within the previous threshold limit of 22 mJ/cm2 over an 8‐h period, as advised by the ACGIH prior to 2022. Results indicated no significant changes in these parameters, suggesting no clinically significant ocular hazards associated with prolonged exposure to 222‐nm UV‐C irradiation under real‐world conditions. Additionally, no delayed side effects, such as pterygium, keratopathies, or cataracts, were observed. Our study supports the safe use of 222‐nm UV‐C for microbial disinfection in occupied environments and provides a robust foundation for updated safety guidelines. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of subconjunctival tranexamic acid (TXA) in reducing intraoperative bleeding, shortening surgery duration, and improving postoperative outcomes in pterygium surgery. Methods: In this double-blind, randomized controlled trial, 50 eyes of 50 patients undergoing pterygium surgery were randomly assigned to receive either subconjunctival injection of 0.25 mL of 5% TXA (TXA group, n = 25) or an equivalent volume of saline (control group, n = 25). Baseline characteristics, including age, gender, working environment, allergies, preoperative logMAR best-corrected visual acuity, and systemic anticoagulant or antiplatelet therapy, were similar between the groups. The primary outcome measures were intraoperative bleeding, surgery duration, and the number of eye spears used. Secondary outcome measures included postoperative visual acuity and pterygium recurrence rates at 3 years post-surgery. Results: No significant differences were observed between the TXA group and the control group in terms of surgery duration (445.3 ± 94.8 s vs. 423.5 ± 80.6 s, P = 0.40), the number of eye spears used (3.5 ± 2.4 vs. 3.5 ± 2.6, P = 0.97), or the weight of absorbed blood (1.94 ± 1.40 grams vs. 1.90 ± 1.25 grams, P = 0.91). Additionally, there were no significant differences in postoperative visual acuity (0.14 ± 0.13 logMAR vs. 0.20 ± 0.19 logMAR, P = 0.39) or pterygium recurrence rates at 3 years post-surgery (8.0% vs. 4.4%, P = 0.60). Subconjunctival TXA injection was safe, with no reported adverse events or complications associated with its use. Conclusion: Subconjunctival injection of TXA did not significantly reduce intraoperative bleeding, shorten surgery duration, or improve postoperative outcomes in pterygium surgery. The intervention was safe and well-tolerated, but further research is warranted to explore alternative interventions or modifications to the surgical technique that may improve outcomes in pterygium surgery. [ABSTRACT FROM AUTHOR]

Background/Objectives: Pterygium is a nonneoplastic elastotic degeneration characterized by subepithelial growth. It manifests as an ocular lesion originating from the bulbar conjunctiva, extending to the corneal surface, and reaching the visual axis in some cases. Although the exact cause is unknown, prolonged exposure to ultraviolet radiation is considered the most significant contributing factor. Chronic irritation and actinic damage are likely responsible for the typical fibrovascular reactions observed in pterygium. Additionally, growth factors, cytokines, and matrix metalloproteinases play roles in the pathogenesis of pterygium. This study compared recurrent and primary pterygium cases at the molecular level to gain new insights into the etiology of pterygium. Methods: Total protein was extracted from surgical samples of patients with primary and recurrent pterygium, and the levels of transforming growth factor beta 1 (TGF-β1), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), IL-8, and IL-10 were analyzed using the enzyme-linked immunosorbent assay technique. Target gene expression levels were analyzed using the ΔΔCt method after cDNA synthesis from isolated RNA, with normalization to GAPDH and quantification performed with SYBR Green PCR Master Mix. Results: Among the studied cytokines, IL-10 levels were higher in primary pterygium than in recurrent pterygium (722.0 ± 600.9/421.4 ± 266.8) (p = 0.0054). Other cytokines (IL-6, IL-8, IL-1β, and TGF-β1) were detected at similar levels in both primary and recurrent pterygium (p = 0.2986). Additionally, the TGF-β1 gene expression was found to be significantly upregulated in recurrent pterygium tissue compared to primary pterygium tissue (p = 0.034). Conclusions: This increase suggests that TGF-β1 may contribute to the recurrence mechanisms of pterygium through processes such as fibroblast activation and tissue remodeling. The higher levels of IL-10 in primary pterygium compared to recurrent pterygium indicate an enhanced early protective response aimed at limiting pterygium progression and controlling the inflammatory process. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to report corneal steep island (CSI) formation following primary pterygium surgery and to identify preoperative pterygium morphological features that predict the likelihood of CSI. Methods: A total of 93 eyes from 84 subjects with primary nasal pterygium, who underwent pterygium excision combined with conjunctival-limbal autograft, were included in this retrospective longitudinal cohort study. CSI was defined using anterior segment swept-source optical coherence tomography (AS SS-OCT). Eyes were divided into two groups: those with postoperative CSI formation (Group 1) and those without postoperative CSI (Group 2). We compared postoperative anterior corneal astigmatism (ACA, in diopters [D]) and root mean square (RMS) values of anterior corneal lower-order (LoA) and higher-order aberrations (HoA) between the groups. Baseline clinical severity grades of pterygium based on the pre-established pterygium body morphology and vascularity, ACA, and AS SS-OCT-guided pterygium morphological profiles (horizontal invasion length [HIL, mm], height [μm], thickness (μm), and residual corneal thickness [RCT]/central corneal thickness [CCT] ratio [RCT/CCT]) were also compared. Results: Postoperative CSI occurred in 26 eyes (28.0%) with a maximum follow-up duration of 22.9±27.4 months. Group 1 exhibited significantly higher postoperative anterior corneal RMS LoA and HoA, as well as the RMS values of the 4th to 6th orders. Although clinical severity grades of pterygium did not differ between groups, baseline ACA was higher in Group 1 (4.56±5.49 D vs. 2.70±3.80 D, P = 0.009). HIL (4.49±0.84 mm vs. 3.77±1.29 mm, P = 0.010) was higher in Group 1, while pterygium height (930.8±84.4 μm vs. 999.3±128.0 μm, P = 0.015) and RCT/CCT ratio (1.07±0.13 vs. 1.14±0.16, P = 0.049) were lower in Group 1. Conclusions: CSI may develop after primary pterygium surgery, particularly in patients with relatively higher preoperative ACA, longer HIL, and shorter height. Given that CSI can significantly increase both lower and higher-order aberrations, it is crucial to anticipate CSI probability and inform patients before surgery. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess the pattern of spheroidal degeneration of cornea (SDC) and its association with other eye diseases at the anterior segment clinic (ASC) in Menelik II Tertiary Referral Hospital. Methods: A hospital-based prospective descriptive study was conducted at ASC, in Menelik II Tertiary Referral Hospital, from May 2021 to September 2022. All enrolled patients meeting the inclusion criteria were selected and assessed with a structured questionnaire. Descriptive analysis was used to describe the study variables in terms of frequency and percentage. The results were presented using tables and figures. Results: Out of 62 cases of SDC, 48 (77.4%) were male and 14 (22.6%) were female. It was more prevalent in the age groups of 60– 69 and 70– 79. Most respondents had outdoor activity (91.9%). A total of 24.2% of patients were found to have Stage I; 35.5% were found to have Stage II; and 40.3% were in Stage III. Posterior subcapsular cataract (PSC) was found in 10 (16.1%) SDC cases, post-trachomatous corneal opacity (CO) in 10 (16.1%) SDC cases, and non-trachomatous CO in 8 (12.9%) SDC cases, but none of them had an association with SDC. Conclusion: Between May 2021 and September 2022, sixty-two cases of SDC were found at the ASC in Menelik II Tertiary Referral Hospital. The data showed a preponderance of SDC in males and older subjects. Stage III and primary types are the leading presentations. It was observed predominantly in individuals who spent most of their time outdoors. Pterygium, corneal opacity, pseudoexfoliation (PXF), PSC, and glaucoma were noted; however, none of these had a significant association with SDC. [ABSTRACT FROM AUTHOR]

Background: Popliteal pterygium syndrome (PPS) is a rare congenital disorder characterized by orofacial, cutaneous, musculoskeletal, and genital anomalies. Surgical interventions are necessary to address the severe knee flexion contracture and equinovarus deformity, but there are no established treatment guidelines. Methods: We present the case of a one-year-old patient with PPS and discuss the challenges in managing the knee deformity. The surgical option chosen for the unilateral knee contracture of 80° consisted of skin management by a large Z-plasty, lengthening of popliteal vessels by grafts, lengthening of the tibial and peroneal nerves by autografts and allografts, capsular releases, and tendon releases to improve mobility and preserve foot sensibility. Results: With a three-year follow-up, the surgical interventions resulted in proper ability to walk freely. Wearing of a foot orthesis was necessary to balance the leg length differences and support the midfoot deformity. Furthermore, sensation of the foot could be restored in terms of touch sensibility and perfusion was always stable during growth. Discussion: The treatment of PPS requires a multidisciplinary approach, considering the rarity and complexity of the syndrome. Surgical interventions aim to release contractures, correct deformities, and preserve foot sensibility. Each treatment option has its advantages and disadvantages, highlighting the need for individualized care. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of postoperative interferon-alpha 2b (IFN-α2b) ophthalmic drops versus intraoperative mitomycin-c (MMC) on preventing pterygium recurrence. Methods: This prospective randomized clinical trial was conducted on patients who were candidates for pterygium surgery. A total of 75 patients were included in the study from December 2021 to December 2022, of which 64 patients (one eye each) were examined and analyzed based on the inclusion criteria. Then the patients were randomly assigned to control groups, intra-operative MMC (32 patients) and the intervention group, IFN-α2b drops after the operation (32 patients). All patients underwent pterygium surgery using the rotational conjunctival flap method. Results: In terms of pterygium grading, 8 (12.5%), 25 (39.06%), and 31 (48.44%) eyes were in grades 1, 2, and 3, respectively. The average size of the pterygium was 3.6 ± 0.7 mm. The grade and size of pterygium had the same distribution in the two groups. There was no statistically significant difference between the two groups in the level of post-operative clinical inflammation. The present study showed no significant difference in complications between the two groups (p = 0.999). The recurrence rate in the control group was 9.4% (3 eyes), and 0% (no recurrence) in the intervention group (p = 0.119). Conclusions: interferon-alpha 2b group did not show a statistically significant difference in preventing pterygium recurrence compared to the mitomycin C group. The post-surgery administration of IFN-α 2b drops can effectively prevent pterygium recurrence with a comparable and even more compelling effect than MMC during surgery. Key message: What is known: • Mitomycin-C is applied intra-operatively to reduce the recurrence risk of pterygium. What is new: • Interferon alpha-2b drops after pterygium surgery can prevent pterygium recurrence with a comparable effect and maybe even more effective than MMC during surgery. • There was no statistically significant difference between the intraoperative MMC and postoperative IF alpha-2b groups in the level of post-operative clinical inflammation and complications. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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]

Pterygium is a common ocular disorder that can result in eye irritation and loss of corneal transparency. Surgical treatment is the main intervention for pterygium removal, with various techniques aimed at minimizing recurrence rates. This review compares the effectiveness of surgical techniques for pterygium treatment in terms of recurrence rates, including the bare sclera technique and conjunctival autograft using biological glue, sutures, and autologous blood. Articles were reviewed from the PubMed, SciELO, and LILACS databases, using the keywords: pterygium surgery, conjunctival autograft with glue or fibrin glue or biological glue or sutures or autologous blood, bare sclera, recurrence. The bare sclera technique showed a recurrence rate of 11%, while the conjunctival autograft technique using biological glue, sutures, and autologous blood demonstrated average recurrence rates of 3.75%, 6.5%, and 6.96%, respectively. The conjunctival autograft technique with biological glue presented the lowest recurrence rates, followed by conjunctival autograft with sutures, autologous blood, and bare sclera. Some studies found no significant difference between the recurrence rates of the suture and biological glue techniques, highlighting the need for further research. [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: 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]

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]

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]

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]

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]

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]

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]

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]

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]

Purpose: To evaluate the effects of different pterygium surgery techniques on ocular surface (OS) in different follow-up periods. Methods: PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang, and China Biology Medicine disc were searched for studies reporting pre- and post-operative OS parameters in pterygium. Results: A total of 33 articles were finally included. Three OS parameters showed relatively consistent changing trends after surgery including ocular surface disease index (OSDI), tear film break-up time (BUT), and score of corneal fluorescein staining (SCFS). They worsened significantly at 1w post-operation and then gradually improved: OSDI and BUT showed obvious improvement in 1 m post-operation (SMD = − 0.58, 95%CI = [− 1.04, − 0.13]; SMD = 0.42, 95%CI = [0.06, 0.78]); SCFS was restored to preoperative levels in 3 m after surgery (SMD = − 0.54, 95%CI = [− 1.16, 0.07]). Another parameter, Schirmer test without anesthesia (SIT), presented transient increase at 1w post-operation (SMD = 0.87, 95%CI = [0.27, 1.47]) and presented a relatively stable improvement after 1 m post-operation (SMD = 0.52, 95%CI = [0.16, 0.89]). All parameters in amniotic membrane graft (AMT) showed better improvement in early stage and they showed non-inferior improvements in the long term compared with conjunctival autograft (CAG). Limbal-conjunctival autograft (LCAG) made excellent improvement to OS in the long term while pterygium excision (PE) showed the worst OS. The type of pterygium (primary and secondary), diabetes mellitus (DM) status, and fixation method had certain effects on the results. Conclusions: OS of pterygium is deteriorated at 1w post-operation then gradually improved to preoperative levels after 1 m post-operation. Among various surgery techniques, LCAG had the best improvement to OS which especially displayed in the long-term outcomes. [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]

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]

Purpose: Low doses of systemic doxycycline (LD-SD) inhibit angiogenesis and the expression of matrix metalloproteases, which are determinants of pterygium progression. This study aimed to compare the recurrence rate and visual outcome of pterygium excision in patients undergoing chronic treatment with LD-SD for chronic refractory blepharitis and LD-SD-naive patients. Methods: A retrospective analysis of patients that underwent surgical excision and conjunctival graft apposition was conducted. Patients were divided in a TETRA group (under LD-SD treatment at the moment of surgery) and a control group. The main outcome was the rate of recurrence at 1 year postoperatively. Secondary outcomes were the comparisons of surface regularity, visual quality, and dry-eye symptoms at 6-week, 6-month, and 1-year follow-up in the two groups. Results: The TETRA group showed a significantly lower rate of 1-year recurrence both in primary (p = 0.034) and recurrent (p < 0.001) pterygia. The best corrected visual acuity (BCVA), astigmatic error, corneal total root mean square (RMS), and ocular surface disease index (OSDI) significantly reduced during the follow-up in both groups. The surface asymmetry index and high-order aberrations (HOAs) significantly reduced only in the TETRA group. The final BCVA was significantly higher, while the OSDI score and total RMS and HOAs were significantly lower in the TETRA group compared to the control. Conclusions: Patients under treatment with LD-SD showed a lower rate of recurrence at 1-year follow-up compared to controls. These patients also experienced higher BCVA and surface regularity and less dry-eye symptoms. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the effects of elevated KDM4D expression and potential therapeutic effects of Lycium barbarum polysaccharide (LBP) on pterygium. Methods: The expression levels of KDM4D in the primary pterygium (n = 29) and normal conjunctiva (n = 14) were detected by immunohistochemistry. The effects of KDM4D on pterygium fibroblasts were detected by the CCK-8 assay, liquid chromatography-mass spectrometry assay, flow cytometry, and scratch wound healing assay. The relative expression of KDM4D in pterygium fibroblasts stimulated by interleukin (IL)-1β, IL-6, IL-8, and LBP was detected by quantitative real-time PCR and Western blot. The effects of LBP on pterygium fibroblasts were detected using flow cytometry and scratch wound healing assays. Results: The expression level of KDM4D in pterygium was higher than that in normal conjunctiva. KDM4D increased the cell viability of pterygium fibroblasts. The differentially expressed genes identified in the LM-MS assay enriched in "actin filament organization" and "apoptosis." KDM4D promoted migration and inhibited apoptosis of pterygium fibroblasts in vitro. Inflammatory cytokines, including IL-1β, IL-6, and IL-8, enhanced the expression of KDM4D in pterygium fibroblasts. LBP inhibited the expression of KDM4D in pterygium fibroblasts and decreased their cell viability. Moreover, LBP attenuated the KDM4D effects on migration and apoptosis of pterygium fibroblasts. Conclusions: Elevated KDM4D expression is a risk factor for pterygium formation. LBP inhibits the expression of KDM4D in pterygium fibroblasts and may be a potential drug for delaying pterygium development. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the prevalence of premalignant and malignant lesions in patients clinically diagnosed with pterygium who underwent excision procedures performed by 1st-year residents in ophthalmology at a teaching hospital between 2018 and 2021. Methods: A cross-sectional analysis was conducted on 274 medical records of patients diagnosed with pterygium who underwent excision procedures from 2018 to 2021 at Hospital PUC-Campinas in Campinas, São Paulo, Brazil. Fifty-four medical records were excluded due to missing essential data. Among the 220 records included for analysis, 239 histopathological results were considered, as 19 patients underwent pterygium excision in both eyes. Results: Out of 239 histopathological results analyzed, 236 (98.74%) were compatible with pterygium, 2 (0.8%) with epithelial dysplasia, and 1 (0.4%) with actinic keratosis. Conclusion: A histopathological study is essential for the accurate differential diagnosis of pterygium. Although the frequency of ocular surface squamous neoplasia is low, premalignant and malignant lesions must be ruled out. Correct diagnosis must be made to allow proper follow-up of the patients and prevent life-threatening lesions. [ABSTRACT FROM AUTHOR]

Context: New pterygium surgery methods have been developed over the years because recurrence is high (30–70%) after simple excision. Aims: To compare the surgical time, ocular discomfort score, and recurrence rate in conventional pterygium surgery, where excision of pterygium and Tenon’s capsule is performed and the area is covered using conjunctival–limbal autograft (CLAU) with supra‑Tenon excision of pterygium (STEP) along with small limbal autograft in patients with primary pterygium. Settings and Design: A Prospective comparative study was conducted at a rural medical college–hospital from November 1, 2017, to October 31, 2019, among 110 participants after ethical approval from Institutional Ethics Committee. Materials and Methods: All participants had primary pterygium of grades I and II depending on corneal encroachment and Tan’s stages T1 and T2 morphologically. Fifty‑five underwent conventional surgery with CLAU (group A), and STEP with small limbal autograft (group B) was performed in the remaining fifty‑five. The follow‑up period was one year. The ocular problem, comfort of subject, recurrence, or other complications were documented, and statistical analysis was carried out with Statistical Package for the Social Sciences (SPSS) software version 21. Results: The mean surgical time was significantly less in group B (38.79 vs. 42.04 minutes) (Z = 11.38, P = 0.001 with confidence interval 10.81–13.38) and ocular discomfort score (ODS) was lower in group B as compared with group A (P < 0.05). Group B had two eyes with recurrence, though not statistically significant (P = 0.49). Conclusion: STEP with small limbal autograft is worth consideration for primary pterygium management. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the expression of placental growth factor (PLGF), neuropilin-1 (NP-1), and neuropilin-2 (NP-2) molecules in primary pterygium tissue compared with normal conjunctival tissue. Methods: The records of 42 patients who underwent excision surgery with autografts for primary pterygium (pterygium group) and 20 patients who underwent conjunctival nevus excision surgery (control group) in the same period were reviewed retrospectively. The samples obtained from the pterygium tissues in the pterygium group and the clean conjunctival tissues adjacent to the nevus in the control group were collected from the archive. Immunohistochemical stains of the primary antibodies—1/100 diluted PLGF, NP-1, and NP-2 (Abcam Cambridge Science Park, UK)—were applied to all groups. Staining intensities and the percentage of positive cells in epithelial, endothelial, stromal, and inflammatory cells were analyzed by an experienced pathologist. Results: The positivity rates of PLGF and NP-2 expression in epithelial, endothelial, stromal, and inflammatory cells were found to be higher in the pterygium group than in the control group (PLGF: p < 0.001, p < 0.001, p = 0.001, and p < 0.001, respectively; NP-2: p < 0.001 for all). Staining intensities for PLGF and NP-2 were higher in the pterygium group than in the control group (PLGF: p < 0.001, p < 0.001, p = 0.005, and p < 0.001, respectively; NP-2: p < 0.001, p < 0.001, p = 0.001, and p < 0.001, respectively). However, no significant differences were found in any cell type in terms of NP-1 expression positivity rates (p = 0.730, p = 0.121, p = 0.524, and p = 0.624, respectively) or staining intensity (p = 0.716, p = 0.147, p = 0.147, and p = 0.780, respectively). Conclusion: PLGF and NP-2 levels were found to be higher in pterygium tissue, while there was no difference in NP-1. These results indicate the possible roles of NP-2 and PLGF in primary pterygium. [ABSTRACT FROM AUTHOR]

Background: Infectious keratitis after pterygium surgery is a rare but potentially devastating complication. The present study presents 5 cases of herpes simplex keratitis (HSK) after pterygium surgery. Case Report: This study was conducted in our clinic in a 5-year period from February 2017 to September 2021. The 5 patients were men, aged between 42 and 73 years, with no prior history of herpes simplex virus (HSV) infections. Symptoms appeared near 1 month (median 30 days, range 10 to 70 days) after primary pterygium surgery. Diagnosis was based on clinical symptoms and laboratory test results, such as tear HSV-sIgA, corneal tissue polymerase chain reaction, and next-generation sequencing of metagenomics. The epithelial (1/5) and stromal (4/5) subtypes of HSK were identified. The patients received topical ganciclovir gel, immunosuppressive eyedrops, and oral acyclovir tablets, along with additional surgical interventions if necessary. Three were healed with conservative therapy, 1 eye required amniotic membrane transplantation due to corneal melt, and 1 was perforated and followed by corneal grafting. Finally, a literature review of previous publications on HSK after ocular surgeries was conducted. Conclusions: HSK is a rare but serious complication that can arise after uneventful pterygium surgery. It is worthy of attention that both epithelial and stromal forms can occur. Timely diagnosis and treatment are crucial to prevent unfavorable outcomes. Consequently, routine corneal fluorescein staining, tear sIgA examination, and corneal scraping for polymerase chain reaction or next-generation sequencing of metagenomics should be performed in any suspected cases. [ABSTRACT FROM AUTHOR]

Patient: Male, 7-month-old Final Diagnosis: Coloboma • congenital • eyelid Symptoms: Defect • lagophthalmos Clinical Procedure: -- Specialty: Ophthalmology Objective: Congenital defects/diseases Background: Congenital eyelid coloboma in children often faces complications such as keratitis, symblepharon, and amblyopia. Repairing defects involving at least 50% of the eyelid margin can be challenging. Acellular dermal allograft (ADA) has achieved excellent results as a substitute in adult eye plastic surgery, with minimal morbidity. This report describes a case of reconstruction of an eyelid defect in a 7-month-old male infant using an ADA. Case Report: A 7-month-old male infant was referred due to congenital eyelid coloboma in the left eye, which affected nearly one-half of the upper and lower eyelids medially, with more than 9 mm of lagophthalmos and lacrimal duct malformation inducing dacryocystitis. Under general anesthesia, A U-shaped silicone drainage tube was inserted in the nasolacrimal duct to ensure an unobstructed lacrimal duct. The symblepharon release, pseudopterygium excision, and medial canthus reconstruction were performed sequentially. Then, the upper eyelid defect was repaired through the advancement of the lateral segment of the eyelid, following lateral cantholysis. A trimmed ADA was placed as a substitute for the tarsal plate in the lower eyelid defect area and sutured with the free edge of the retractor. Finally, the lower and lateral skin orbicular muscle flap was advanced to cover the acellular dermis composite graft. The postoperative eyelid morphology was satisfactory. At 6 months after surgery, lower eyelid retraction gradually appeared. Conclusions: ADA is presented as an effective solution for reconstructing significant eyelid defects of infants. However, the potential of postoperative eyelid retraction still deserves future research and refinement in surgical techniques. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of subconjunctival dexamethasone compared to normal saline on conjunctival autograft harvesting in patients undergoing pterygium surgery. Methods: Fifty-two eyes of 52 patients who underwent pterygium excision combined with autologous conjunctival graft (CAG) using releasable suture were included in this prospective interventional study. The patients were randomized into two groups of 26 patients each. Group A consisted of patients in whom CAG was harvested using subconjunctival 0.5 ml of 0.4% dexamethasone sodium phosphate and in group B patients, normal saline was used. The patients were assessed for postoperative pain, foreign body sensation, and watering as the subjective signs of inflammation and conjunctival inflammation and lid edema as the objective signs of inflammation at 12 and 24 h postsurgery. Results: The mean age of group A and B patients was 47.69 + 13.09 and 46.00 + 10.76 years, respectively. The male:female ratio was 1.6:1 in group A and 1.1:1 in group B. The mean surgical time in group A was 243.96 ± 52.13 s and in group B was 258.08 ± 43.99 s. Postoperative pain, foreign body sensation, and watering were significantly lower in group A patients than in group B patients at both 12 and 24 h postoperatively (group A: 4.65 ± 1.33, 4.88 ± 1.73, and 3.85 ± 1.43, respectively, at 12 h; 1.89 ± 1.03, 1.69 ± 1.09, and 1.69 ± 0.97, respectively, at 24 h and group B: 6.42 ± 0.95, 6.65 ± 0.98, and 6.27 ± 1.40, respectively, at 12 h; 3.27 ± 1.43, 3.12 ± 1.25, 2.58 ± 1.14, respectively, at 24 h) (P < 0.001). Conjunctival inflammation was significantly lower in group A at 12 h (P < 0.05) and 24 h (P < 0.05) after surgery compared to group B. Lid edema failed to show any significant (P = 0.17) difference with respect to severity in both the groups at 12 and 24 h (P = 0.699). Conclusion: Subconjunctival dexamethasone decreased patient discomfort following pterygium surgery. The dexamethasone group had reduced conjunctival inflammatory signs without any notable complications. [ABSTRACT FROM AUTHOR]

Objective: The frequency of recurrence is a critical factor in the utilization of different treatments for pterygium. The present study was undertaken to compare the pterygium recurrence rates after bare sclera excision with that of argon laser therapy. Methods: Sixty eyes of 53 patients with primary pterygium were included in this prospective, interventional case series. The participants were randomly categorized into 2 groups each consisting of 30 subjects. In the first group, pterygium excision was performed using bare sclera technique whereas the second group received argon laser therapy alone. The patients were examined for pterygium recurrence and complications at postoperative 1 and 7 days as well as in months 1, 3, and 6 after the operation. All analyses were performed using SPSS software (version 17.0) and P-values less than 0.05 were considered significant. Results: Pterygia recurred in 7 eyes (23.3 %) in the first group (i.e. bare sclera group) and in 4 eyes (13.3 %) in the second group (i.e. argon laser therapy group). The recurrence rate was not significantly different between the two groups. No ocular or systemic complication developed till the end of follow-up. Conclusion: Argon laser photocoagulation of pterygium may be more favorable for patients with coagulopathy or a history of conjunctival surgery. The coagulation effect of the argon laser may prevent severe conjunctival bleeding, which may occur after surgical excision in patients with coagulopathy. [ABSTRACT FROM AUTHOR]

Aims: Growing clinical evidence suggests that not all patients with rheumatoid arthritis (RA) benefit to the same extent by treatment with tripterygium glycoside (TG), which highlights the need to identify RA‐related genes that can be used to predict drug responses. In addition, single genes as markers of RA are not sufficiently accurate for use as predictors. Therefore, there is a need to identify paired expression genes that can serve as biomarkers for predicting the therapeutic effects of TG tablets in RA. Methods: A total of 17 pairs of co‐expressed genes were identified as candidates for predicting an RA patient's response to TG therapy, and genes involved in the Lnc‐ENST00000602558/GF1 axis were selected for that purpose. A partial‐least‐squares (PLS)‐based model was constructed based on the expression levels of Lnc‐ENST00000602558/IGF1 in peripheral blood. The model showed high efficiency for predicting an RA patient's response to TG tablets. Results: Our data confirmed that genes co‐expressed in the Lnc‐ENST00000602558/IGF1 axis mediate the efficacy of TG in RA treatment, reduce tumor necrosis factor‐α induced IGF1 expression, and decrease the inflammatory response of MH7a cells. Conclusion: We found that genes expressed in the Lnc‐ENST00000602558/IGF1 axis may be useful for identifying RA patients who will not respond to TG treatment. Our findings provide a rationale for the individualized treatment of RA in clinical settings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]