Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery

PURPOSE:To measure the incidence and evaluate the clinicopathologic characteristics, surgical outcome, and prognosis of conjunctival granulomas (CGs) after pterygium surgery. METHODS:This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 20...

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Veröffentlicht in:Cornea 2018-08, Vol.37 (8), p.1008-1012
Hauptverfasser: Zhang, Zongduan, Yang, Zhengwei, Pan, Qintuo, Chen, Pinyi, Guo, Linning
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container_end_page 1012
container_issue 8
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container_title Cornea
container_volume 37
creator Zhang, Zongduan
Yang, Zhengwei
Pan, Qintuo
Chen, Pinyi
Guo, Linning
description PURPOSE:To measure the incidence and evaluate the clinicopathologic characteristics, surgical outcome, and prognosis of conjunctival granulomas (CGs) after pterygium surgery. METHODS:This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 2004 to May 2017. The outcomes were evaluated in 52 eyes (50 patients) that developed CGs after pterygium surgery. RESULTS:CGs developed in 52 of 3851 operated pterygium eyes (1.4%) over a 13-year period. Mean patient age was 54.4 ± 9.9 years (range, 28–72 years). The mean onset time of the CG after pterygium surgery was 42.8 ± 18.3 days (range, 12–90 days). The location of the granulation was around the free conjunctival flap. Histopathologic examination showed inflammatory granulation tissue with large amounts of inflammatory cell infiltration. All CGs were successfully cured by surgical excision combined with corticosteroid eye drops. No patient had recurrence at a mean follow-up time of 6 months. Kaplan–Meier analysis showed that the difference of the cumulative survival rate of pterygium surgery methods was statistically significant (P < 0.001). Using the multivariate Cox regression model, 2 factors were found to be not correlated with the survival rate of patients with CGssex (P = 0.17) and the category of pterygium (primary or recurrent) (P = 0.96). CONCLUSIONS:CGs are an uncommon potential complication of pterygium surgery. The histologic characteristics, including the proliferation of inflammatory granulation tissue with large amounts of inflammatory cell infiltration, could be helpful to diagnose this disease. Surgical excision combined with corticosteroid drops proved to be a simple and effective treatment of CGs.
doi_str_mv 10.1097/ICO.0000000000001647
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METHODS:This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 2004 to May 2017. The outcomes were evaluated in 52 eyes (50 patients) that developed CGs after pterygium surgery. RESULTS:CGs developed in 52 of 3851 operated pterygium eyes (1.4%) over a 13-year period. Mean patient age was 54.4 ± 9.9 years (range, 28–72 years). The mean onset time of the CG after pterygium surgery was 42.8 ± 18.3 days (range, 12–90 days). The location of the granulation was around the free conjunctival flap. Histopathologic examination showed inflammatory granulation tissue with large amounts of inflammatory cell infiltration. All CGs were successfully cured by surgical excision combined with corticosteroid eye drops. No patient had recurrence at a mean follow-up time of 6 months. Kaplan–Meier analysis showed that the difference of the cumulative survival rate of pterygium surgery methods was statistically significant (P &lt; 0.001). Using the multivariate Cox regression model, 2 factors were found to be not correlated with the survival rate of patients with CGssex (P = 0.17) and the category of pterygium (primary or recurrent) (P = 0.96). CONCLUSIONS:CGs are an uncommon potential complication of pterygium surgery. The histologic characteristics, including the proliferation of inflammatory granulation tissue with large amounts of inflammatory cell infiltration, could be helpful to diagnose this disease. Surgical excision combined with corticosteroid drops proved to be a simple and effective treatment of CGs.</description><identifier>ISSN: 0277-3740</identifier><identifier>EISSN: 1536-4798</identifier><identifier>DOI: 10.1097/ICO.0000000000001647</identifier><identifier>PMID: 29877925</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Aged ; Conjunctiva - pathology ; Conjunctival Diseases - diagnosis ; Conjunctival Diseases - etiology ; Follow-Up Studies ; Granuloma - diagnosis ; Granuloma - etiology ; Humans ; Middle Aged ; Ophthalmologic Surgical Procedures - adverse effects ; Postoperative Complications ; Pterygium - surgery ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Cornea, 2018-08, Vol.37 (8), p.1008-1012</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4027-e7a3005ba87bd374de3b7f340512ad346a504297ad93692b41cdf106bab286333</citedby><cites>FETCH-LOGICAL-c4027-e7a3005ba87bd374de3b7f340512ad346a504297ad93692b41cdf106bab286333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29877925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Zongduan</creatorcontrib><creatorcontrib>Yang, Zhengwei</creatorcontrib><creatorcontrib>Pan, Qintuo</creatorcontrib><creatorcontrib>Chen, Pinyi</creatorcontrib><creatorcontrib>Guo, Linning</creatorcontrib><title>Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery</title><title>Cornea</title><addtitle>Cornea</addtitle><description>PURPOSE:To measure the incidence and evaluate the clinicopathologic characteristics, surgical outcome, and prognosis of conjunctival granulomas (CGs) after pterygium surgery. METHODS:This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 2004 to May 2017. The outcomes were evaluated in 52 eyes (50 patients) that developed CGs after pterygium surgery. RESULTS:CGs developed in 52 of 3851 operated pterygium eyes (1.4%) over a 13-year period. Mean patient age was 54.4 ± 9.9 years (range, 28–72 years). The mean onset time of the CG after pterygium surgery was 42.8 ± 18.3 days (range, 12–90 days). The location of the granulation was around the free conjunctival flap. Histopathologic examination showed inflammatory granulation tissue with large amounts of inflammatory cell infiltration. All CGs were successfully cured by surgical excision combined with corticosteroid eye drops. No patient had recurrence at a mean follow-up time of 6 months. Kaplan–Meier analysis showed that the difference of the cumulative survival rate of pterygium surgery methods was statistically significant (P &lt; 0.001). Using the multivariate Cox regression model, 2 factors were found to be not correlated with the survival rate of patients with CGssex (P = 0.17) and the category of pterygium (primary or recurrent) (P = 0.96). CONCLUSIONS:CGs are an uncommon potential complication of pterygium surgery. The histologic characteristics, including the proliferation of inflammatory granulation tissue with large amounts of inflammatory cell infiltration, could be helpful to diagnose this disease. Surgical excision combined with corticosteroid drops proved to be a simple and effective treatment of CGs.</description><subject>Adult</subject><subject>Aged</subject><subject>Conjunctiva - pathology</subject><subject>Conjunctival Diseases - diagnosis</subject><subject>Conjunctival Diseases - etiology</subject><subject>Follow-Up Studies</subject><subject>Granuloma - diagnosis</subject><subject>Granuloma - etiology</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Ophthalmologic Surgical Procedures - adverse effects</subject><subject>Postoperative Complications</subject><subject>Pterygium - surgery</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0277-3740</issn><issn>1536-4798</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFP3DAQha2KqrvQ_oMK-cgli2M7dnJcRbAgrbSV2p6jieMQUyde7BjEv8dllwpxqA_jked7z6OH0PecrHJSycvberci704uuPyElnnBRMZlVZ6gJaFSZkxyskCnIdwnSEpBv6AFrUopK1os0VhbMxnl9jAPzro7o3A9gAc1a2_CbFTAMHV4HjT-GX0ag8W7OCs3aux6XLvpPk5qNo_pfeNhitaNEPC6T3r8I5XnOxPHV23qv6LPPdigvx3vM_T7-upXfZNtd5vber3NFE87Z1oCI6RooZRtl_bvNGtlzzgpcgod4wIKwmkloauYqGjLc9X1OREttLQUjLEzdHHw3Xv3EHWYm9EEpa2FSbsYGpqchBCSFQnlB1R5F4LXfbP3ZgT_3OSk-Rt0k4JuPgadZOfHH2I76u6f6C3ZBJQH4MnZFEP4Y-OT9s2gwc7D_71fAL1oix4</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Zhang, Zongduan</creator><creator>Yang, Zhengwei</creator><creator>Pan, Qintuo</creator><creator>Chen, Pinyi</creator><creator>Guo, Linning</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201808</creationdate><title>Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery</title><author>Zhang, Zongduan ; Yang, Zhengwei ; Pan, Qintuo ; Chen, Pinyi ; Guo, Linning</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4027-e7a3005ba87bd374de3b7f340512ad346a504297ad93692b41cdf106bab286333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Conjunctiva - pathology</topic><topic>Conjunctival Diseases - diagnosis</topic><topic>Conjunctival Diseases - etiology</topic><topic>Follow-Up Studies</topic><topic>Granuloma - diagnosis</topic><topic>Granuloma - etiology</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Ophthalmologic Surgical Procedures - adverse effects</topic><topic>Postoperative Complications</topic><topic>Pterygium - surgery</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Zongduan</creatorcontrib><creatorcontrib>Yang, Zhengwei</creatorcontrib><creatorcontrib>Pan, Qintuo</creatorcontrib><creatorcontrib>Chen, Pinyi</creatorcontrib><creatorcontrib>Guo, Linning</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cornea</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Zongduan</au><au>Yang, Zhengwei</au><au>Pan, Qintuo</au><au>Chen, Pinyi</au><au>Guo, Linning</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery</atitle><jtitle>Cornea</jtitle><addtitle>Cornea</addtitle><date>2018-08</date><risdate>2018</risdate><volume>37</volume><issue>8</issue><spage>1008</spage><epage>1012</epage><pages>1008-1012</pages><issn>0277-3740</issn><eissn>1536-4798</eissn><abstract>PURPOSE:To measure the incidence and evaluate the clinicopathologic characteristics, surgical outcome, and prognosis of conjunctival granulomas (CGs) after pterygium surgery. METHODS:This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 2004 to May 2017. The outcomes were evaluated in 52 eyes (50 patients) that developed CGs after pterygium surgery. RESULTS:CGs developed in 52 of 3851 operated pterygium eyes (1.4%) over a 13-year period. Mean patient age was 54.4 ± 9.9 years (range, 28–72 years). The mean onset time of the CG after pterygium surgery was 42.8 ± 18.3 days (range, 12–90 days). The location of the granulation was around the free conjunctival flap. Histopathologic examination showed inflammatory granulation tissue with large amounts of inflammatory cell infiltration. All CGs were successfully cured by surgical excision combined with corticosteroid eye drops. No patient had recurrence at a mean follow-up time of 6 months. Kaplan–Meier analysis showed that the difference of the cumulative survival rate of pterygium surgery methods was statistically significant (P &lt; 0.001). Using the multivariate Cox regression model, 2 factors were found to be not correlated with the survival rate of patients with CGssex (P = 0.17) and the category of pterygium (primary or recurrent) (P = 0.96). CONCLUSIONS:CGs are an uncommon potential complication of pterygium surgery. The histologic characteristics, including the proliferation of inflammatory granulation tissue with large amounts of inflammatory cell infiltration, could be helpful to diagnose this disease. Surgical excision combined with corticosteroid drops proved to be a simple and effective treatment of CGs.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29877925</pmid><doi>10.1097/ICO.0000000000001647</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Conjunctiva - pathology
Conjunctival Diseases - diagnosis
Conjunctival Diseases - etiology
Follow-Up Studies
Granuloma - diagnosis
Granuloma - etiology
Humans
Middle Aged
Ophthalmologic Surgical Procedures - adverse effects
Postoperative Complications
Pterygium - surgery
Retrospective Studies
Treatment Outcome
title Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery
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