Comparative study on the use of conjunctival autograft with or without mitomycin-C in pterygium surgery

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the recurrence rate after conjunctival autograft alone versus conjunctival autograft with mitomycin-C in the treatment of primary and recurrent pterygium.<br /><strong>METHODS:</strong> This was a prospective, randomized, interventional comparative study of patients with primary and recurrent pterygium who were randomized to receive either simple excision with conjunctival autograft (CA) or simple excision with CA and mitomycM-C applied. They were followed up for 6 months and observed for recurrence of the pterygium. Statistical analyses were used to compare the 2 groups.<br /><strong>RESULTS:</strong> Fifty-eight patients (62 eyes) diagnosed with primary and recurrent pterygium were evaluated. The mean age was 44.81 ± 12.35 years (range 25 to 70 years). Thirty eyes were treated with conjunctival autograft (15 primary, 15 recurrent) and 32 eyes (17 primary, 15 recurrent) with conjunctival autograft combined with Mtraoperati-ve application of low-dose raitomycin. -C (0.02% for 3 minutes). The mean follow-up period was 25 ± 1.40 months (range 24 to 28 months). There was a 3.22% recurrence rate (2 eyes) from the recurrent pterygium group. There was no significant difference 11.1  the rate of recurrence (p = 0.53) between the 2 treatments for both primary and recurrent pterygium. No mitomycM C-related complication was observed during the length of the study.<br /><strong>CONCLUSION:</strong> Conjunctival autograft surgery alone for primary and recurrent pterygium is effective and safe in reducing the recurrence rate of pterygium within" 6 months.</p>

Intraocular inflammation as the main manifestation of Rickettsia conorii infection.

OBJECTIVE: To report the clinical features and management of seven cases of intraocular inflammation caused by Rickettsia infection and review published literature. METHODS: Rickettsia conorii or Rickettsia spp. infection was diagnosed based on the following criteria: (1) positive serology according to the European Guidelines, (2) titer normalization after specific treatment, and (3) complete resolution of ophthalmic disease and accompanying symptoms after antibiotic therapy. RESULTS: Seven patients were referred for uveitis of unknown etiology. All came from regions where Mediterranean spotted fever is prevalent. One patient met the European guidelines criteria for Rickettsia spp. infection, while the other six cases met the criteria for R. conorii infection. The main symptoms were visual loss, floaters, eye redness, photophobia, and ocular pain. Predominant ophthalmic signs included vasculitis, choroiditis, vitritis, and macular edema. All patients required antibiotic treatment that resulted in the remission of the infection. Doxycycline was the first choice and the only antibiotic used to treat four patients. One patient needed ciprofloxacin as a second antibiotic after not responding to doxycycline. Two patients had doxycycline as a second antibiotic after not responding primarily to sulfonamides (which had been given after 2-3 days of doxycycline gastric intolerance); one of these patients needed ciprofloxacin as a third antibiotic. CONCLUSION: Intraocular inflammation can occur as the main manifestation of Rickettsia conorii or Rickettsia spp. infection. It should be considered as a differential diagnosis for uveitis especially for patients living in countries where this infection is endemic in the world. Antibiotic treatment remains effective in the management of Rickettsia infection.