Abstract:Background: In recent studies Hyaluronidase (Hyalase) is playing a very important role in treating the Pterygium. It has been accepted for sometimes now that environmental factors are responsible for development of pterygium. More recently, it has been clear that UV light exposure is most important environmental influence. Majority of pterygia occurring on nasal limbus has been attributed to the fact that reflected sunlight is preferentially focused at this point. But exact way in which UV light interacts with limbus and cornea to produce a pterygium is unknown.
Aim and Objectives: To evaluate the efficacy of Hyaluronidase (Hyalase)in treatment of early Pterygium. The study was conducted to find out clinical effect of inj. hylase in the early pterygium at limbus upto 1 to 1.5 mm size in cornea.
Materials and Methods: The present study was a prospective study to analyze the role of Hyaluronidase (Hyalase) in the treatment of early pterygium In the Department of Ophthalmology, Varun Arjun Medical College & Rohilkhand Hospital, Banthara, Shahjahanpur Uttar Pradesh, over a period of 1year from January 2018 to December 2018. A total number of 50 patients were assessed with regards to their clinical diagnosis, vital parameters and presentations. Patients having complain of redness foreign bodies sensations watering were examine on the slit lamp for the extension of pterygium on limbus. Visual acuity and fundus examination were done. 1500 i.u. of hylase injection was dissolved in 2 cc of d.w. out of this 0.25 cc of solution taken in insulin syringe and 1 cc of xylocaine 2% was also added and given at the neck of pterygium with 26 guaze needle by lifting the neck with tooth forcep. Eye speculum was applied and paracaine drops instilled on the cornea and conjunctiva before this.
Results: In our series females comprised of 2/3rd of the total number of patients studied (22 males to 28 females). 70% of the patients were in the age group of 21 to 50 years [Table - 2]. InteÂrestingly 81% were in the occupation which exposed them to reÂcurrent local irritation [Table - 3]. This was consistent with the theÂsis that pterygium is more common in people exposed to outdoor dusty work. Study of 50 patients were carried out between the age group of 1 to 50 years. Treatment was given to all in the form of s/c inj. of hylase for three days alternatively. Out of this 28 patients were female and 22 male. Patients having complain of redness foreign bodies sensations watering were examine on the slit lamp for the extension of pterygium on limbus. Visual acuity and fundus examination were done. 1500 i.u. of hylase injection was dissolved in 2 cc of d.w. out of this 0.25 cc of solution taken in insulin syringe and 1 cc of xylocaine 2% was also added and given at the neck of pterygium with 26 guaze needle by lifting the neck with tooth forcep. Eye speculum was applied and paracaine drops instilled on the cornea and conjunctiva before this. Antibiotic ointment was applied and pad was given over the eye ask the patients to seat for half an hour. Then take away the pad and see that there is no active bleeding from the conjunctiva. Ask the patient to go home with dark goggles and instilling astregent eye drops and antibiotic with non-steroid eyedrops 3 times a day. And advice to come after 48 hours for further treatment.
Conclusions: 50 cases of pterygium were studied after use of Hyaluronidase (Hyalase). Six bi-weekly injecÂtions of 0.25 cc of Hyaluronidase with 0.1 cc of 1% Novocaine soluÂtion were given at the neck of the pterygium. The drug was found to be of definite value in early cases of pterygium with disappeaÂrance of growth in 80% of the cases. Progressive and malignant pterygiums showed diminution in size and vascularisation in 60 and 70 67o cases respectively. We did not encounter any morÂbidity or adverse effects in any of these patients.
