Faculty of Medicine

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    Evaluation of the tear film in eyes with pterygium and after its surgical excision using the limbal inferior-lateral conjunctival autotransplantation procedure
    (2010)
    Aim To determine the eventual abnormalities of the tear function at patients with unilateral pterygium and after its surgical excision using conjunctival autotransplantation from the limbal inferior-lateral conjunctiva. Method The tear function was examined on 60 patients with unilateral pterygium before and after surgical excision of the pterygium with conjunctival autotransplantation using the graft from the limbal inferior-lateral conjunctiva. Schirmer test with and without local anesthetic and the break-up time of the tear film were used on the healthy eye, the eye with pterygium and after the pterygium surgery on the same patient. Results The mean time of the tear film break-up time (BUT) is 13,4 sec (10,7 sec - 16,2 sec) on the healthy eye. This mean time was significantly shorter, 5,6 sec (9,7 sec ± 4,7 sec), in the same patients but measured at the eye with pterygium. After 1 month of the operation and excision of the pterygium the mean time of the BUT was significantly longer (11,7sec ± 2,7 sec). Measured by the Schirmer test, the size of the wet area on the Whatman filter paper with local anesthesia was 14mm (12mm - 16mm) on the healthy eye and 4,5mm (3,0mm - 6,0mm) on the eye with pterygium. Postoperatively, the size of the wet area increased, i.e. the area was 14,8mm (12,7mm – 16,9mm). The wet area’s size measured by the Schirmer test without local anesthesia before the surgery of pterygium was 4,80 mm (3,50 mm - 6,1mm), after the surgery 15,50mm (13,5mm -17,50mm) and on the healthy eye 16mm (15,0mm-17,0mm). Conclusion The tear function in patients with primary pterygium improves after its surgical excision with the conjunctival autotransplantation using the graft from the limbal inferior-lateral conjunctiva. Thus it can be concluded that pterygium has a close relationship with the dryness of the eye.
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    COMPARATIVE STUDY OF PTERYGIUM SURGERY
    (2004)
    Aim: To evaluate the success rates of surgical techniques for primary pterygium-pterygium excision with conjunctival autograft transplantation and pterygium excision with complete suture of conjunctiva without transplantation Methods: 75 cases with primary pterygium were prospectively reviewed. Outcome was evaluated in terms of recurrence of pterygia onto the cornea. The patients were divided into 2 groups: 40 eyes were operated with recurrence of pterygia onto the cornea. The patients were divided into 2 groups:40 eyes were operated with conjunctival autograft transplantation (20 cases by pterygium invades the cornea 3mm and 20 cases by pterygium invades the cornea 3mm and more).35 cases were operated by pterygium with complete suture of conjunctivae without transplantation (20 cases by pterygium invading the cornea 3mm and 15 cases by pterygium invading the corneae 3mm and more) Results:Mean follow up was 12 months (2-24 months) 4 out of 40 recur (10%) after the conjunctival autograft transplantation, while 14 of 35 cases recur (40%) after the pterygium excision with complete suture of conjunctiva without transplantation.One surgeon performed the surgery. Conclusion: Conjunctival autografts in pterygia have excellent efficacy against recurrence within the first year.
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    PTERYGIUM-a case report
    (2006)
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    Ivanovska M.
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    Antova M
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    Dzajkovska E
    A sporadic case of bilateral nasal and temporal pterygium on both eyes is present in this abstract. After four operations on all pterigia with limbal conjunctival autotransplantation from superior and inferior part of the bulbar conjunctiva there was no recurrence of the pterygium. The postoperative vision was improved. Pathohistological investigation of the pterygium samples confirmed the diagnosis.
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    Pterygium excision with limbal autograft transplantation and its histopathological caracteristics of the epithelium
    (2015)
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    INTRODUCTION: Pterygium is a chronic fibro vascular and degerenative process and originates from the basal limbal stem cells. AIM: The eximination of morphology and cytoceratin expresion of the epithelium of primary stationary and progressive pterygium. Also the method of pterygium excision with limbal autographt transplantation was evaluated. The post operative complications as recidives were evaluated. MATHERIAL AND METHOD: Impression cytology and imunohistohemical staining with antikeratin antibodies were performed in 140 eyes with pterygium. The pterygium was surgically excised using the limbal grapht from imferior or superior bulbar conjunctiva. Avidin – Biotin (ABC and LSAB) technique was performed for the imuno histochemical investigation of the tissue slides of pterygium on Poly-L-lysine-glasses. RESULTS: There were epithelial diversity in the tissues slides of primary stationary and progressive pterygium. Diversity of epithelium was found between the different cuts of the same pterygium depending which part of the pterygium was examined. The areas of squamous epithelial prone to keratinisations was relatively frequent. Also there were areas of erosion and even dysplastic areas. Goblet cells were found isolated or associated and were intensively PAS positive. The post operative incidence of recidivating pterygium was 7%. CONCLUSION: Pterygium shows significant changes in the epithelium even in the different slides of the same pterygium and its not associated with the stadium of the primary pterygium. Pterygium excision with limbal autographt transplantation is a surgical method of choice for primary stationary and progressive pterygium.
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    Angiogenesis in pterygium: histopathological and imunohistochemical study
    (2016)
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    Pterygium is an active invasive inflammatory process, a key feature of which is focal limbal failure. It is a triangular conjunctival-epithelial overgrowth covering the cornea, a long term and recurrent illness that leads to permanent decrease of the visual acuity and esthetic changes of the eye’s anterior segment. Aim: The correlation between the stationary and progressive primary pterygium and recurrent pterygium was determined histo pathologically and immunohistochemically using the CD31 and CD34 antibodies for the identification of the vascular endothelium and micro density, i.e. angiogenesis in the pterygium tissue after pterygium excision with conjunctival autograft transplantation from the inferior bulbar conjunctiva. Material and methods: This study compares two groups of primary pterygium, stationary pterygium (30 patients) and progressive pterygium (30 patients), and one group of recurrent pterygium (30 patients), that were surgically treated with refractive surgical method of pterygium excision with conjunctival autograft transplantation from the inferior bulbar conjunctiva. In the period of 2009 to 2011, the surgeries were performed at the University Eye Clinic, while the histopathological and immuno histochemical study was performed at the Institute of Pathology using CD31 and CD34 antibodies for the angiogenesis identification. Results: No statistically significant difference was found in the vascular angiogenesis between the progressive and recurrent pterygium (Z=-0,258 p=0,7958), however statistically significant difference was found in the vascular angiogenesis between the stationary and either progressive (Z=-3,770 p=0,00016) or recurrent (Z=-3,866 p=0,00011) pterygium (using Mann-Whitney U Test). Conclusion: The higher developed angiogenesis in both primary progressive and recurrent pterygium, may support previous suggestions that angiogenesis may play a role in the formation of pterygia and its postoperative recurrence.
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    A sporadic case of bilateral nasal and temporal pterigia on both eyes-case report
    (2017)
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    A rare case of bilateral nasal and temporal pterygium is presented in the study. All four pterygia were operated with limbal conjunctival auto transplantation from superior or inferior part of the bulbar conjunctiva. There was no recurrence. Samples of the surgery excised pterygium tissue were patohistologicaly examined.
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    Item type:Publication,
    COMPARATIVE STUDY OF PTERYGIUM SURGERY
    (Macedonian Academy of Sciences and Arts, 2011)
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    Stankovic Babic, G
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    Zdravkovska Jankuloska, M
    Aim: To compare and evaluate the success rates of various surgical techniques of pterygium excision, including pterygium excision with complete suture of conjunctivae (PESC), pterygium excision with conjunctival auto graft transplantation with graft from the inferior temporal bulbar conjunctiva (ITBC) and pterygium excision with conjunctival auto graft transplantation with graft from the superior temporal bulbar conjunctiva (STBC). Material and methods: 120 cases with primary unilateral nasal pterygium were evaluated. Outcomes were evaluated in terms of complication and recurrence after pterygium excision. The patients were divided into 3 groups: 1. Group of 40 patients with primary pterygium (pterygium’s length over the cornea 1,0 mm and more) treated by the technique of pterygium excision with complete suture of conjunctiva (PESC). 2. Group of 40 patients with primary pterygium (pterygium’s length over the cornea 1,0 mm and more) treated by the technique of pterygium excision with the conjunctival auto graft transplantation with graft from the inferior temporal bulbar conjunctivae(ITBC). 3. Group of 40 patients with primary pterygium (pterygium’s length over the cornea 1,0 mm and more) treated by the technique of pterygium excision with conjunctival auto graft transplantation with graft from the superior temporal bulbar conjunctivae(STBC). Results: Mean follow up time after the surgery was 15 months (6 to 24 months). 12 out of 40 (30%) recurred after the pterygium excision with complete suture of conjunctivae (PESC). Three out of forty (7,5%) pterygium recurred after the modified surgical techniques of pterygium excision with conjunctival auto graft transplantation with graft from the inferior temporal bulbar conjunctiva (ITBC). Five out of forty (10,2%) recurred after the pterygium excision with conjunctival auto graft transplantation with graft from the superior bulbar conjunctivae (STBC). All the recurrences (8 cases) in both pterygium groups treated by the transplantation procedures were after excision of progressive pterygium when the pterygium reaches more than 3 mm of corneae. Only one surgeon performed all 120 surgeries. Conclusion: A comparison of the group’s demonstrated that the recurrence rate was highest in the group without transplantation, using only complete suture of the conjunctiva. The excision of pterygium with conjunctival autograft transplantation from the inferior or superior temporal bulbar conjunctiva are highly efficient in terms of low recurrence rates. The modified surgical technique using the graft from the inferior temporal bulbar conjunctivae is preferred because the superior bulbar conjunctiva is intact for eventual future surgical intervention.
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    A sporadic case of bilateral nasal and temporal pterygium on both eyes
    (2018)
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    A rare case of bilateral nasal and temporal pterygium is presented in the study. All four pterygia were operated with limbal conjunctival auto transplantation from superior or inferior part of the bulbar conjunctiva. There was no recurrence. Samples of the surgery excised pterygium tissue were pathohistologicaly examined
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    A comparative study of visual acuity before and after pterygium excision by conjunctival autotransplantation techniques
    (Faculty of Medicine, University Ss. Cyril and Methodius in Skopje, 2020)
    Purpose: To evaluate the visual acuity and corneal astigmatismus preoperatively and after the excision of pterigia by conjunctival auto transplantation techniques. Material and methods: 120 patients were divided in two groups of 60 patients depending of the used surgical methods. A group of 60 patients (group No.1) treated by the technique of pterygium excision with the conjunctival auto graft transplantation with graft from the inferior temporal bulbar conjunctivae (ITBC) and a group of 60 patients (group No.2) treated by the technique of pterygium excision with the conjunctival auto transplantation with graft from the superior temporal bulbar conjunctivae (STBC). The both groups were subdivided on two groups, a group of 30 patients with stationery pterygium and 30 patients with progressive pterygium. Preoperatively and postoperatively, all patients were assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. Results: In 76,6% of the patients from the group No.1 and in 60% of the patients from the group No.2 with stationary pterygium the postoperative visual acuity was significantly better with no statistical significant difference between the groups (p=0,1724). In 86,6% of the patients from the group No.1 and in 63,3 % of the patients from the group No.2 with progressive pterygium, the postoperative visual acuity was significantly better with no statistical significant difference between the groups (p=0,1417). Conclusion: Pterygium excision with conjunctival auto transplantation procedures (STBC and ITBC) results in significant reduction in astigmatism which leads to improvement in visual acuity.