Understand past and New Surgical Procedures for Pterygium

A pterygium condition of your eye is when a lump of tissue develops into a triangular shape and it generally grows from your eye’s conjunctiva onto your eye’s cornea. It may occur in one or both of your eyes and it will normally form in the area next to the nose.

In the past, there was a debate about which approach would be the best option for pterygium surgeries, and whether doctors had to use fibrin glue or sutures to do conjunctival grafts. Both of these procedures had their advantages and disadvantages in terms of factors such as recurrence, cosmetics, surgical time and postoperative complications.

However, there is now a new procedure where doctors use the blood of a patient to fix this condition. Though it’s not yet been tested by a controlled randomized trial, most of the earlier results suggest that it can reshape this debate altogether.

The difference between sutures and glue

Sutures

Auto-grafts of the conjunctival by using the suturing procedure is generally rated the gold standard. Additionally, these grafts are very stable and also its recurrence rate of about fifteen percent is a plus point. Though, its cosmetic results were only acceptable and not really good.

On the negative side, this surgery in itself may take thirty to forty minutes, as well as having problems that are suture-related. These can include granuloma formation, chronic inflammations, and postoperative discomfort.

Fibrin glue

Doctors have used fibrin glue in different surgical procedures such as corneal perforation closures and corneal lamellar grafting. Lately, they also use it for suture-free conjunctival auto-grafts which offer a significant improvement.

The fibrin glue is simpler and faster and works nearly every time. The time for surgery is cut closely to half the time of a sutured procedure, and most patients have reported less discomfort and postoperative pain.

Except for the fact that fibrin glue cost more as what sutures do, it’s also difficult to obtain in certain countries. Because the glue is a product that is blood-derived, it might carry a risk for potential transmission of prion and viral diseases. These risks are basically theoretical, although, it can be a big issue and more importantly there might be a risk of dehiscence.

The new procedure with no glue or sutures

The newest procedure is a graft auto-blood fixation, which is a technique that is also called glue and suture-free autologous graft. Problems, discomforts, and costs related to the other two procedures can be avoided with this new procedure. Except for the fact that an autologous blood procedure is natural, it has no associated risks or extra cost, and it will overcome any postoperative irritations that patients might experience to a huge degree.

The procedure

In this procedure, after the surgeon removes the pterygium, as well as associated conjunctivas, he/she will allow a very slim layer of blood clotting to form on the area that is bare. Any extra bleeding can be stopped by using a surgical tampon directly. After this, a slim conjunctival Tenon-free auto-graft, either with inclusion or without some limbal stem cells will form.

Once the graft is properly aligned, it’s placed in the area that is bare over the layer of blood. With forceps, the doctor will hold the edges in place, normally for about 3 – 5 minutes in order to have enough time for the graft fixation to take place.

Certain factors to be considered

Like any procedure that is new, auto-blood fixation grafting involves some learning curves. Although, this procedure probably is less challenging as what glue or sutures are.

Selection of patients

Any patients that use certain blood thinners or aspirin regularly, or when they suffer from a condition of coagulation deficiency factors, won’t be candidates for undergoing auto-blood fixation grafting.

The risk of developing dehiscence

One of the disadvantages might be a graft loss risk immediately in the period of postoperative. However, once a graft stays in its place for a time period between twenty-four to forty-eight hours, it will stick around. In a case study that involves sixty-three patients over the period of one year, not one lost its graft.

A risk of any recurrence

The risk factor for recurrence is very low if the procedure is performed properly. Among fifty test subjects that received a procedure of auto-blood grafting, not one experienced any recurrence over a timeline of 4 years.

Hemorrhoids Also Known as Piles and What You Should Know

Hemorrhoids Also Known as Piles and What You Should Know

Hemorrhoids or piles are veins that swell in your anus or rectum’s lower part. Sometimes these walls of blood vessels can stretch very thin and the veins will become bulgy and irritated when your stomach works. This is also a very common reason for you to experience rectal bleeding. It’s typically not very dangerous and can clear up within a few weeks.

Different kinds of hemorrhoids

There are basically two kinds of hemorrhoids, which is internal and external. External piles or hemorrhoids stem from your anal canal and those that are internal develops in the rectum just above your anal canal.

This doesn’t mean that one is more dangerous as what the other one is. Even though both of them may cause some problems. This will depend on the degree and size of your hemorrhoids.

However, if they are left untreated, the internal ones can start bleeding, and the external ones might cause a blood clot/thrombosis that could cause severe and acute pain.

The causes of hemorrhoids/piles

Some patients can be at a higher risk to develop hemorrhoids, especially if it runs in the family. Pressure buildup in the lower part of your rectum may affect the blood flow that can cause the veins to swell. This can happen due to extra weight such as during pregnancy or when you are obese.

Additionally, it may also develop due to:

You might push very hard because of constipation during your bowl movements.

If you straining yourself when something is physically hard to do, such as lifting a heavy object.

When you sit or stand for long periods, you will also be at a greater risk.

Other reasons might be diarrhea if is lasts for a long time, and vomiting, coughing, or sneezing can make it worse.

When will it be time to contact your doctor?

When you experience any kind of bleeding from your rectum.

If your hemorrhoids cause a lot of discomfort or pain.

With problems that persist in spite of over-the-counter medicines or creams you tried.

In the case when your stool is tarry or maroon in color, which is generally seen as a sign that there is bleeding.

If you experiencing a lot of bleeding together with faintness or dizziness, it’s important to immediately seek medical emergency care. Hemorrhoids might be seen as just a small problem to your health, but if you experience anything that doesn’t feel right, you need to consult your doctor just to make sure.

Some ways how you can prevent hemorrhoids

Hemorrhoids might be very common but once they bleed, become itchy, or cause pain, you need to take it seriously.

Here are some strategies that might prevent them from disrupting your everyday life.

Change your diet to more fiber

By changing your diet through taking in more fiber which is a natural way to ensure your stomach works regular will be the easiest. This can be accomplished through adding extra natural fiber to your diet or with supplements. You need to get between twenty-five and thirty grams of fiber every day.

Good sources of food with fiber will include the following:

Fruits, like bananas, apples, pears, and raspberries.

Vegetables, like Brussels sprouts, broccoli, green peas, and artichoke.

Whole grains, like brown rice, oatmeal, bran flakes, and barley.

Legumes, like baked beans, lima beans, black beans, lentils, and split peas.

Water intake

This is a cheap and simple strategy to prevent hemorrhoids. Although, very few people actually will go out and do it. Adequate water intake together with your high-fiber diet can ensure healthy and regular bowel movements. Drink between 6 and 8 glasses of water every day and it will not only keep you regular, but it’s also good for your overall health.

Don’t ignore the urge to go

It’s very important to go to the toilet if the need arises. Don’t be too busy and ignore the calling as you can aggravate the situation and cause strain if you wait for later. Your body will tell you when and what it needs, so please listen to it. It’s one of the biggest problems that most people have.

Straining is not good for you

Straining will put extra pressure on your rectum’s veins, which may cause bleeding and pain associated with the hemorrhoids. You need to relax when you go for a bowl movement and don’t push too hard. Also, try to avoid lifting heavy objects or anything that might put a strain on the veins.