Effect of triamcinolone acetonide injection on pterygium recurrence in postoperative subconjunctival patients

Nika Bellarinatasari*  -  UNIVERSITAS ISLAM SULTAN AGUNG, Indonesia

(*) Corresponding Author

Pterygium is an eye disorder characterized by fibrovascular tissue from the bulbar conjunctiva encroaching on the cornea. Inflammation has been suggested to play a role in the pathogenesis of pterygium, indicated by elevated levels of anti-inflammatory cells and markers. Triamcinolone acetonide is a steroid commonly used to treat eye diseases. This study evaluated the effects of anti-inflammatory triamcinolone acetonide injection after the pterygium surgery. This study included 71 eyes of 71 patients. The patients were divided into two groups: triamcinolone and control group. Each eye received a subconjunctival triamcinolone injection of 2.5 mg/ 0.1 ml or no after pterygium surgery with bare sclera technique. The infusion was done around the excision area. Before and after the surgery, the ocular pressure was evaluated. Topical steroid antibiotics and oral analgesics were administrated. The outcomes were assessed one day, week, three weeks, and one month after surgery under slit-lamp examination and noncontact tonometry. The evaluated outcomes were the presence of fibrovascular tissue and intraocular pressure. This study was done by a surgeon and assisted by a nurse. There are 71 eyes in this study; 10 eyes are lost during follow-up. The 61 eyes were divided into 28 triamcinolone and 33 control group. The recurrence of pterygium was found in 2 (39. 3%) of the triamcinolone group and in (10.7%) of the control group (p=0.16). Eight eyes showed increased ocular pressure, and one patient developed granuloma. Subconjunctival triamcinolone injection after pterygium surgery did not significantly reduce pterygium recurrence.

Keywords: Pterygium; Bare-sclera; Triamcinolone injection; Recurrency

  1. Athanasiadis, Y. Tsatsos, M., Sharma, A. and Hossain, P. (2013). Subconjunctival Triamcinolone Acetonide in the Management of Ocular Inflammatory Disease. Journal of Ocular Pharmacology and Therapeutics, 29(6): 516–522. doi: 10.1089/jop.2012.0208.
  2. Govindasamy, S. and Reddy, S. C. (2022). Outcome of Excision of Primary Pterygium with Bare Sclera Technique : A Study of 80 Eyes in Malaysia. European Journal of Medical and Health Sciences,4(4): 17–20. doi: 10.24018/ejmed.2022.4.4.1379 S.
  3. Gupta, R. K., Kumar, S. and Lakra, M. D. (2017). Intraoperative Triamcinolone Versus Bevacizumab as an Adjunct to Conjunctival Autograft in Primary Pterygium Surgery. International Journal of Contemporary Medical Research, 4(2): 557–560. https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1313_v1_mar_19.pdf
  4. Maheshwari S. (2007). Pterygium-induced corneal refractive changes. Indian Journal of Ophthalmology, 55 (5): 383-386. https://doi.org/10.4103%2F0301-4738.33829
  5. Mpyet C and Oko H. (2000). Results of intra-operative 0.5 mg/ml mitomycin C with 20 mg depo steroid in the treatment of primary pterygium.Central African Journal of Medicine, 46 (2): 330-332. https://doi.org/10.4314/cajm.v46i12.8580
  6. Nuzzi, R. and Tridico, F. (2018). How to minimize pterygium recurrence rates: clinical perspectives. Clinical Ophthalmology, 12, 2347–2362. doi: 10.2147/OPTH.S186543.
  7. Panda, A., Das, G.K., Tuli, S.W., Kumar, A. Randomized trial of intraoperative mitomycin C in surgery for pterygium. American Journal of Ophthalmology, 125 (1): 59-63. doi: 10.1016/S0002-9394(99)80235-9.
  8. Purnamanita, Budu, Hatta, M., Massi, M.N., Natzir, R., Ichsan, A.M., and Sujuti, H. (2020). The Effectiveness of Triamcinolone Injection on Risk of Postoperative Operations with the Conjunctiva Autograft Technique and Its Association with Change of VEGF mRNA Expression. Biomedical & Pharmacology Journal, 13(2): 543–549. doi: http://dx.doi.org/10.13005/bpj/1916.
  9. Sakti, F. K. (2021). Updates on the Mechanism and Management of Pterygium : A Brief Review. European Journal of Medical and Health Sciences,3(3): 6–11. doi: 10.24018/ejmed.2021.3.3.949.
  10. Wanzeler, A.C.V., Barbosa, I.A.F., Duarte, B., Borges, D., Barbosa, E.B., Kamiji, D., et al., (2019). Mechanisms and biomarker candidates in pterygium development. Arq Bras Oftalmol, 82(6): 528–36. doi: 10.5935/0004-2749.20190103.

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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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