Betül TUĞCU, Çiğdem COŞKUN, Ulviye YİĞİT

Pterjium cerrahisinden sonra topikal siklosporin a tedavisinin etkinliği

Amaç: Limbal konjonktival otogreft transplantasyonu ile pterjium cerrahisi uygulanan hastalarda pterjiyum nüksünü önlemek için postoperatif topikal siklosporin A %0,05 kullanımının etkinliğini ve güvenilirliğini araştırmak. Yöntem ve Gereçler: Kasım 2009-Ocak 2010 tarihleri arasında primer nazal pterjiyum tanısı alan 30 hasta calışma- ya dahil edildi. On beş hasta tedavi grubu, 15 hasta kontrol grubu olacak şekilde iki gruba ayrıldı. Postoperatif 7. gün, tedavi grubuna günde 2 kez topikal siklosporin A % 0,05 başlandı. Kornea üzerinde 0,5 mm’den fazla fibrovasküler büyüme nüks olarak değerlendirildi. İstatistiksel analizler icin NCSS 2007&PASS 2008 Statistical Software (Utah, USA) programı kullanıldı. Sonuç: İki grup arasında yaş, cinsiyet ve pterjiyum büyüklüğü açısından fark yoktu. Topikal siklosporin A %0,05 ile tedavi edilen grupta 2 (%13,3) hastada, kontrol grubunda ise 7 (%46,7) hastada nüks görüldü. İki grup arasındaki bu fark istatistiksel olarak anlamlı bulunmadı (p>0,05). Kontrol grubunun nüks görülme rölatif riski tedavi grubundan yaklaşık 2 (%95 Cl: 1,04-4,96) kat fazla olarak saptandı. Tedavi grubunda 2 hastada nüks görülmüş olup ortalama nüks süresi 3±1 ay; kontrol grubunda ise 7 hastada nuks gorülmüş olup ortalama süre 2,071±0,254 ay olarak saptandı. Sonuç: Bu çalışma, pterjiyum eksizyonu sonrası topikal siklosporin A %0,05 kullanımının pterjiyum nüksünü önle- mede etkili olduğu gösterilmiş fakat istatistiksel olarak bu etkinlik ispatlanamamıştır.

The effectiveness of topical cyclosporine a after pterygium surgery

Aim:To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) eye drops in pre- venting the recurrence of pterygium after excision of primary pterygium with limbal conjunctival autograft trans- plantation technique. Material and Method: Thirty patients with primary nasal pterygium were involved in the study between December 2009 and January 2010. The patients were divided into two groups: a treatment group of 15 patients and a control group. At the 7th postoperative day, topical 0.05% cyclosporine A was applied twice a day to the treatment group. Recurrence was defined when there was a fibrovascular growth >0.5 mm on the cornea. All statistical analyses were performed using NCSS 2007& PASS 2008 Statistical Software (Utah, USA). Results: The difference between two groups for age, sex and pterygial size was not statistically significant. The pterygium recurred in 2 (13.3%) patients in the treatment group and in 7 (46.7%) patients in the control group. The difference between the two rates was not statistically significant (p>0,05). The control group had about 2 (95% Cl: 1,04-4,96) times higher risk of pterygium recurrence compared with the treatment group. In the treatment group, re- currence of pterygium was observed in 2 patients with a mean recurrence time of 3±1 months. In the control group, recurrence was observed in 7 patients with a mean recurrence time of 2,071±0,254 months. Conclusion: This study suggests that primary excision of pterygium with postoperative use of 0.05% cyclosporine A isn’t efficient.

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