蕭裕泉醫師眼科筆記

Cornea editor's corner of the world Treating ocular surface squamous neoplasia -------------------------------------------------------------------------------- by Michelle Dalton EyeWorld Contributing Editor Ocular surface squamous neoplasia (OSSN) is not a common condition but is one that all clinicians need to be able to recognize. An early diagnosis with a small lesion results in a very good prognosis. However, a delay in diagnosis can lead to a lesion that involves a large area of epithelium including a significant amount of the limbal stem cells and conjunctival. Treating these larger lesions is more difficult and has a higher recurrence rate. All clinicians should be aware of the clinical findings of OSSN: irregular, thickened limbal, corneal and conjunctival epithelium, and neovascularization. The abnormal epithelium typically arises from the limbus and can progress centrally over the cornea or posteriorly over the conjunctiva or in both directions. An atypica...

Complicated cataract cases Cornea editor's corner of the world Pterygium surgery trends and pearls by Vanessa Caceres EyeWorld Contributing Editor Pterygium is a common problem that, if managed incorrectly, can lead to a more significant clinical condition post-op. A recurrent pterygium is a different disease than a primary pterygium. Recurrences are more inflamed, progress more rapidly, lead to more conjunctival scarring, are more difficult to surgically remove, and are more likely to lead to loss of vision. Therefore surgeons need to use an operative technique that first and foremost reduces the recurrence rate and leads to the best outcome. Clinical trials have definitively shown that the bare sclera technique has a very high recurrence rate (25-90%) and should never be used as the sole procedure. Excision with some adjunct therapy is the treatment of choice. Surgeons have many options available to them and have to make surgical decisions that they feel are the correc...

July 2011‧ Eye World Study finds new possible treatment for pterygium by Matt Young EyeWorld Contributing Editor  A patient is injected with bevacizumab. A recent study indicates that these injections may be a possible treatment for pterygium Source: María H. Berrocal, M.D.     In the future, it may be possible that the cure for pterygium isn't total surgical excision. A new report hints that some concoction of bevacizumab (Avastin, Genentech, South San Francisco, Calif.) could be injected and reduce the size of pterygium.    The research, published online in Cornea in September 2010, found that intralesional bevacizumab injection reduces the size of pterygium and is well tolerated. However, there was no clinically significant impact on the reduction in pterygium size. The fact that bevacizumab worked to reduce pterygium size still holds promise.    Current methods to excise pterygium surgically and prevent recurrence have side eff...