nepjoph 2012.pmd - Nepalese Journal of Ophthalmology

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Ganekal S Ganglion cell complex scan Nepal J Ophthalmol 2012;4(8):236-241 of the retinal ganglion cell layer and its alterations with lesions of the visual pathways. Springfield, IL: Charles C Thomas. Details required Quigley HA, Dunkelberger GR, Green WR (1989). Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol; 107:453–464. Quigley HA, Miller NR, George T (1980). Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage. Arch Ophthalmol.; 98:1564–1571. Sommer A, Miller NR, Pollack I, Maumenee AE, George T (1977).The nerve fiber layer in the diagnosis of glaucoma. Arch Ophthalmol; 95:2149– 2156. Glovinsky Y, Quigley H, Pease ME (1993). Foveal ganglion cell loss is size dependent in experimental glaucoma. Invest Ophthalmol Vis Sci; 34:395–400. Greenfield DS, Bagga H, Knighton RW (2003). Macular thickness changes in glaucomatous optic neuropathy detected using optical coherence tomography. Arch Ophthalmol; 121:41–46. Tan O, Chopra V, Lu AT, Schuman JS, Ishikawa H, Wollstein G, Varma R, Huang D (2009). Detection of macular ganglion cell loss in glaucoma by Fourier-domain optical coherence tomography. Ophthalmology; 116(12):2305-14. Source of support: nil. Conflict of interest: none 241
Sharma R et al Conjunctival autograft transplantation in pterygium Nepal J Ophthalmol 2012; 4(8):242-247 Original article Outcome of conjunctival autograft transplantation in pterygium surgery in a community based hospital in Nepal Sharma R, Marasini S, Nepal BP Department of Ophthalmology, Kathmandu University Hospital, Dhulikhel, Nepal Abstract Introduction: The mainstay of treatment for pterygium is surgical excision with or without a graft. The most common problem with this intervention is recurrence, for which a multitude of factors have been described. Objective: To evaluate the recurrence rate of pterygium in conjunctival autologous graft transplantation after its excision in people living in a hilly region of Nepal Materials and methods: A prospective interventional study was conducted in patients undergoing pterygium excision with conjunctival autologous graft transplantation. The patients were followed up for 20 months. Any recurrence of pterygium was noted during this period. Results: Thirty four patients with an age range of 29 to 65 years (mean 43.88±9.19 years) were included. Female predominated (n=21, 61.8%) in the study. Service holders formed a majority of the cases (n=14, 41.2%) followed by farmers (n=10, 29.4%, OR 0.019, 95% CI = 0.002 to 0.209). Ocular discomfort was the main presenting complaint. Dry eye was seen in 30 patients (88.23%). Most of the patients (26, 76.5%) had a grade II pterygium. Graft displacement was the main complication in two (5.88%) patients and recurrence of pterygium was found in three (8.82%). Conclusion: Conjunctival autologous transplantation is a safe and effective method for the treatment of pterygium with a minimal recurrence rate. Key-words: Autologous graft, conjunctiva, pterygium, recurrence Introduction A pterygium is a fibrovascular, wing-shaped encroachment of conjunctiva onto the cornea. A multitude of factors are associated with the development of pterygium; the most common cause being UV type B radiation (Moran et al, 1984; Taylor et al, 1992). Recent studies have suggested that p53 genes, human papillomavirus, localized Received on: 12.01.2012 Accepted on:03.05.2012 Address for correspondence: Dr Ranjana Sharma, MD (Ophth) Department of Ophthalmology, Kathmandu University Hospital, Dhulikhel, Nepal Tel: (977)- 9841501308 Email: ranjana_sharma66@yahoo.com limbal stem cell deficiency and uncontrolled cell proliferation may be associated with the development of pterygium (Di Girolamo et al, 2004; Gallagher et al, 2001; Reisman et al, 2004; Tan et al, 2000). The currently accepted pathogenesis is the Ultraviolet light-induced damage to the limbal stem cell which leads to the subsequent conjunctivalisation of the cornea (Dushku et al, 1994). The mainstay of pterygium treatment is surgical excision of the head, neck and body of the 242
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Page 5 and 6: Review articles Artificial drainage
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