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Session Title: Special Cases
Session Date/Time: Monday 07/10/2013 | 17:00-18:30
Paper Time: 17:54
Venue: Elicium 1 (First Floor)
First Author: : E.Mata Diaz SPAIN
Co Author(s): : C. de Pablo Martin C. Montón Gimenez E. Conesa Hernandez L. Martinez Godoy F. Sanchez-Carnerero
To evaluate long term effect of LASER argon thermoablation of neovascular tufts in 27 patients with recurrent pterygium after escisional surgery with conjunctival autograft.
Prospective, single-center study
Twenty seven patients with recurrent pterygium were selected for the study after informed consent and compromise of 1 year follow up. Treatment of early postoperative recurrence of pterygia by thermoablation with laser argon of the neovascular tufts was performed. Patients were prospectively followed for at least 12 months after photocoagulation. Treatment was considered to be successful when the recurrence was hold up, or a decrease in thickness of the connective tissue was observed. Number of session, LASER argon parameters (spot size, watts and number of laser impacts) were recorded in each patient. Laser was applied in two parallel rows on the scleral side of the limbus with confluent burns. Each patient received two sessions elapsed 1 week. Retreatment was evaluated 1 month after. Side effects were recorded. Long term follow-up was made in all patients with 1, 5 mean follow up (range from 1 to 3 years).
The median age was 34 years (range from 26 to 43 years). Sex ratio was 15 female 12 male. They had all recurrent pterygium after escisional surgery with conjunctival autograft. Recurrence was treated by mean at the 9th week (range from 6 to 11) after surgery. All 27 patients tolerated well the treatment with itching and transient red eye as only complaint reported. Bleeding in area of treatment was noted in 4 cases (15%). Retreatment was needed in 5 cases ( 18%). Laser argon mean parameters were 100msg with a spot size of 200 microns, 450 watts and 123 impacts in each session. Greater vessels needed higher watts to be occluded. At first year control 4 patients (15%) were not conform with the esthetic result and underwent surgery. All remaining patients (85%) had acceptable appearance with no recurrence after more than 1 year follow up. In 52% patients there was a regression of the recurrence and in the remaining 47% patients the recurrence was hold up. Impending corneal recurrence gave the best results with 100% of success.
The data from this study suggest that photocoagulation of neovascular tufts of impending recurrences of pterygia can avoid new surgery in at least 85% of the recurrences .This effect is permanent, safe and well tolerated.
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