Abstract
Purpose :
Low dose of systemic doxycycline (LD-OD) has been proven to produce antiangiogenic effects and to inhibit both the expression and activation of matrix metalloproteases (MMP)-2 and MMP-9, whose expression is particularly relevant to pterygium progression.The aim of the study is to assess the outcome of both primary and recurrent clinically significant pterygium after surgical excision and conjunctival graft apposition in a cohort of patients undergoing chronic treatment with LD-OD for chronic refractory blepharitis.
Methods :
Retrospective analysis of patients that underwent surgical excision and conjunctival graft apposition was conducted.Included patients were under LD-OD treatment before surgery and were affected by pterygium involving > 5 keratoscopic rings.Patients were divided in two groups: primary pterygium and recurrent pterygium.Rate of recurrence in both groups 1 year postoperatively was registered.Surface regularity, visual quality and dry-eye symptoms at 1-month, 3-months and 6-months follow-up were also monitored.
Results :
In primary pterygium group 1/36 patients (2.77%) showed recurrence at 1-year follow-up.Best corrected visual acuity(BCVA) improved at 6-weeks follow-up (p=0.037), with a significant decrease in astigmatic refractive error (p = 0.021). Surface asymmetry index(SAI) and corneal total root mean square (RMS) were significantly lower at 1-year follow-up (p=0.042 and p =0.039 respectively).Ocular surface disease index (OSDI) score significantly reduced at 6-weeks follow-up (p=0.025).In recurrent pterygium group clinical relapse was detected in 1/24 patients (4.16%) at 1-year visit. BCVA significantly increased (p<0.001) and astigmatic refractive error significantly decreased (p=0.002) at 6-weeks examination. They also experienced a decrease in SAI(p=0.004), longitudinal spherical aberration (LSA)(p=0.021), Symmetry Index of Curvature (IC)(p=0.043), RMS(p=0.036), high-order aberrations (HOAs)(p=0.041) and OSDI score (p=0.005).
Conclusions :
LD-OD treated patients with primary or recurrent pterygium show a lower rate of recurrence at 1-year follow-up compared to data in literature. Surface regularity and symptoms also improve in these patients after surgery.Prospective studies on a larger population are encouraged.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.