Pterygium is a common and frequently-occurring disease in ophthalmology. It is called "pterygium panning eye" in traditional Chinese medicine, and it is commonly called "fish meat". It is generally believed that it is a chronic inflammatory disease caused by external stimuli. It is a victim of one or both eyes. It is named because its shape resembles the wings of an insect. It is a kind of neoplastic tissue on the bulbar conjunctiva and cornea of the palpebral fissure, which gradually increases after invading the cornea, and can even cover the pupil area and seriously affect vision. It is the degeneration, hypertrophy, and hyperplasia of the bulbar conjunctiva and subconjunctival tissues of the palpebral fissure, which develop into the cornea and appear triangular. It is more common in outdoor workers, and fishermen and farmers have the most disease. It may be related to long-term chronic irritation such as wind, sunlight, and smoke. Pterygium is generally more common in the large corner of the eye, and sometimes it can grow on the cornea, blocking the pupil and reducing vision. How is pterygium formed? Its cause is still unclear. It is generally believed that the disease is related to long-term field work, exposure to sand, dust, cold, heat and sunlight. At the same time, overwork, lack of sleep and chronic inflammation of the conjunctiva are also predisposing factors. In recent years, it has also been believed that the pterygium is closely related to the overdevelopment of the control ligament of the medial rectus muscle and genetic factors.
Prevention of pterygium is mainly to avoid smoke, dust and sun stimulation as much as possible, pay attention to eye hygiene, the occurrence of pterygium is closely related to the damage of ultraviolet rays, and outdoor workers or favorites who are exposed to ultraviolet rays and the glare and reflection of strong light for a long time For people who are outdoors, wearing anti-UV glasses has a certain preventive effect. Suffering from trachoma or other types of conjunctivitis should be treated promptly, and at the same time, you should pay attention to adequate sleep, regular life, and avoid dry stools and other systemic adjustments. The pterygium can be divided into three parts in terms of its shape: it grows on the cornea and is the tip of the pterygium, called the head. It is fanned back and slightly raised. The neck is located at the junction of the cornea and conjunctiva. The broad part that stretches to the surface of the conjunctiva is called the body, and there are many new blood vessels on it. Pterygium can be divided into the following two types: (1) Progressive type: The pterygium has a wide neck, many new blood vessels, hyperemia, and hypertrophy. The body is triangular and stretches to both sides. The head is obviously raised, growing into the surface of the cornea, and even blocking the pupils. (2) Static type: The pterygium stops when it grows to the limbus. It is not hyperemic, is reddish, has a flat head, and a thin neck and body. It is in a relatively static state, but does not go away on its own. In addition, there is a kind of pseudo-pterygium, which can grow on any part of the limbus. It is generally small and gray-white on the surface, but there are also thicker ones. Scar tissue is often formed due to trauma, corneal edge ulcers, chemical or thermal burns of the conjunctiva, and generally no longer grows after formation. It is completely different from the previous two types of pterygium in nature. There are two commonly used methods for the prevention and treatment of pterygium: (1) Drug treatment, for the static type, the pterygium does not invade the cornea and does not affect the vision, so treatment is not necessary. Patients with trachoma or chronic conjunctivitis can be treated with antibiotics or glucocorticoid eye drops. (2) Those who have progressive pterygium or pterygium growth into the cornea that affect vision should go to the hospital for pterygium resection. After pterygium surgery is performed according to traditional methods, the recurrence rate is higher, about 30%-40%. The stimulation of the operation causes the chemotaxis and aggregation of polymorphonuclear leukocytes (they can release vascular growth factors), which is the cause of neovascularization and recurrence after surgery. Due to the high incidence of pterygium and the high recurrence rate after traditional surgical methods, the world ophthalmology community has conducted in-depth research on this operation, and continuously improved and perfected the surgical method. Pterygium removal under a microscope and auto-conjunctival flap transfer or limbal stem cell transplantation are commonly used. The pterygium is completely removed during the operation and the corneal surface at the resection site is smoothed. Because as long as the cornea is smooth and there is no small cornea, there will be no tear pool and tear retention, and the recurrence factors will be reduced to a minimum. At the same time, self-conjunctival transplantation eliminates the stimulating factors that produce new blood vessels, thereby preventing the recurrence of pterygium. In addition, the use of mitomycin eye drops after surgery can inhibit the proliferation of DNA and fibroblasts, and can also prevent the recurrence of pterygium.
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May 2021
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