Factores predictivos de recurrencia del pterigium primario Predictive factors of primary pterygium recurrence

El tratamiento exitoso del pterigium constituye un desafío constante para los oftalmólogos. Este tratamiento es netamente quirúrgico, con la intención de lograr su perfeccionamiento sistemático han surgido innumerables técnicas, que se emplean según las particularidades de cada paciente o las del cirujano. El pterigium es de etiología multifactorial, lo cual genera una gran complejidad, cuando se trata de seleccionar la técnica quirúrgica más adecuada. Con el propósito de analizar factores predictivos de recurrencia del pterigium: genéticos, histológicos, angiográficos y morfológicos, se realizó esta revisión bibliográfica.<br>The successful treatment of pterygiyum is a permanent challenge to be met by ophthalmologists. This kind of therapy is purely surgical and a number of techniques have emerged to attain its systematic improvement, which are used in line with the particularities of every patient or those of the surgeon. Pterygiyum has a multifactor etiology, so it is very complex to select the most suitable technique to operate it. The present literature review was made to analyze predictive factors of pterygium recurrence such as genetic, histological, angiographic and morphological factors

Estudio comparativo del uso de mitomicina C en el pterigium recidivante Comparative study of the use of mitomycin C in recurrent pterygium

INTRODUCCIÓN: El pterigium constituye un problema en la práctica oftalmológica por su alta prevalencia y elevada frecuencia de recidiva. El propósito de este estudio fue el de comparar la técnica quirúrgica de injerto autólogo de conjuntiva con células límbicas más mitomicina C, con la de injerto de membrana amniótica con mitomicina C, en pterigium recidivante, en cuanto a la tasa de recidiva, complicaciones posoperatorias inmediatas, y tiempo libre de recidiva (meses). MÉTODOS: Se realizó un ensayo clínico controlado prospectivo con n= 57 pacientes portadores de pterigium recidivante. Se conformaron 2 grupos: grupo 1, injerto de conjuntiva antólogo con células límbicas más mitomicina C; y el grupo 2, injerto de membrana amniótica más mitomicina C. Se comparó el comportamiento de las técnicas empleadas a partir de sus resultados. El seguimiento fue ± de 1-6 meses. RESULTADOS: La agudeza visual mejoró en 60 % de los casos. La recidiva fue de 2 % para el grupo 1 y de 6 % para el grupo 2. CONCLUSIONES: El método de injerto conjuntival con limbo resultó más efectivo para el tratamiento del pterigium recidivante. Él método de membrana amniótica constituye una alternativa para el tratamiento de casos en los cuales no sea viable la aplicación de de injerto antólogo.<br>INTRODUCTION: Pterygium is a problem in ophthalmology practice because of its high prevalence and frequency of recurrence. The objectives of this study was to compare the surgical technique of autologous conjuctival graft with limbal cells plus mitomycin C with that of amniotic membrane graft treated with mitomycin C in recurrent pterygium in terms of recurrence rates, immediate postoperative complications and recurrence-free time (months). METHODS: A prospective controlled clinical assay was carried out in 57 patients suffering recurrent pterygium. They were divided into two groups; the group 1 that had autologous conjuctival graft with limbal cells plus mitomycin C, and the group 2 with amminotic membrane graft plus mitomycin C. The used techniques were compared on the basis of their results. The follow-up period extended from one to six months. RESULTS: Visual acuity improved in 60 % of cases. Recurrence occurred in 2 % of cases in group 1 and 6 % in group 2. CONCLUSIONS: The conjunctival graft with limbal cells method was more effective for the recurrent pterygium treatment. The amniotic membrane method constitutes an alternative therapy for cases in which autologous graft is not applicable

Specific oral tolerance induction (SOTI) in pediatric age: clinical research or just routine practice?

Specific Oral Tolerance (SOTI) is a promising therapy of food allergy, specially for IgE-mediated cow milk allergy (CMA) in pediatric age. Randomized controlled trials have reported that about 35% of children, at least 5 years of age, became full tolerant to cow milk proteins after SOTI. Regard to the safety, literature describes about 200 children who underwent SOTI, with no fatal events. Nevertheless, a considerable percentage of those children (15%-20%) had to stop SOTI, because of important adverse effects. Numerous protocols have been described, some audacious and other prudent, however all demand an intense commitment either of the doctors and of the families. The information about the follow up of the children who underwent SOTI are still insufficient. For these reasons, we think that SOTI is still an experimental therapy