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A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series

Received: 26 August 2021     Accepted: 13 September 2021     Published: 30 September 2021
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Abstract

Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.

Published in American Journal of Clinical and Experimental Medicine (Volume 9, Issue 5)
DOI 10.11648/j.ajcem.20210905.13
Page(s) 142-146
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Pinguecula, Sublimation, Soft Surgery, PANIS Method, Atmospheric Low-temperature Plasma

References
[1] Weisenthal, R. W., et al., External disease and cornea. 2019: American Academy of Ophthalmology.
[2] Mimura, T., et al., Severity and determinants of pinguecula in a hospital-based population. Eye & Contact Lens, 2011. 37 (1): p. 31-35.
[3] Frucht-Pery, J., et al., Treatment of inflamed pterygium and pinguecula with topical indomethacin 0.1% solution. Cornea, 1997. 16 (1): p. 42-47.
[4] Mimura, T., et al., Pinguecula and contact lenses. Eye, 2010. 24 (11): p. 1685-1691.
[5] Jeong, J., et al., The Improvement of Dry Eye Symptoms after Pinguecula Excision and Conjunctival Autograft with Fibrin Glue. Journal of ophthalmology, 2019. 2019.
[6] Panchapakesan, J., F. Hourihan, and P. Mitchell, Prevalence of pterygium and pinguecula: the Blue Mountains Eye Study. Australian and New Zealand journal of ophthalmology, 1998. 26: p. S2-S5.
[7] Fotouhi, A., et al., Prevalence and risk factors of pterygium and pinguecula: the Tehran Eye Study. Eye, 2009. 23 (5): p. 1125-1129.
[8] Rezvan, F., et al., The prevalence and determinants of pterygium and pinguecula in an urban population in Shahroud, Iran. Acta Medica Iranica, 2012: p. 689-696.
[9] Ahn, S. J., et al., One-year outcome of argon laser photocoagulation of pinguecula. Cornea, 2013. 32 (7): p. 971-975.
[10] Jung, S., et al., Vascular regression after pinguecula excision and conjunctival autograft using fibrin glue. Eye & contact lens, 2017. 43 (3): p. 199-202.
[11] Laroussi, M., Plasma medicine: a brief introduction. Plasma, 2018. 1 (1): p. 47-60.
[12] Claiborne, D., et al., Low-temperature atmospheric pressure plasma enhanced tooth whitening: The next-generation technology. International Journal of Dental Hygiene, 2014. 12 (2): p. 108-114.
[13] Shashurin, A., et al., Living tissue under treatment of cold plasma atmospheric jet. Applied Physics Letters, 2008. 93 (18): p. 181501.
[14] Zimmermann, J. L., et al., Disinfection Through Different Textiles Using Low-temperature Atmospheric Pressure Plasma. Plasma Processes and Polymers, 2012. 9 (8): p. 792-798.
[15] Nejat, F., et al., Safety evaluation of the plasma on ocular surface tissue: An animal study and histopathological findings. Clinical Plasma Medicine, 2019. 14: p. 100084.
[16] Schiffman, R. M., et al., Reliability and validity of the ocular surface disease index. Archives of ophthalmology, 2000. 118 (5): p. 615-621.
[17] Bell, A., Pinguecula. Journal of Visual Communication in Medicine, 2006. 29 (2): p. 82-83.
[18] Arenas-Archila, E., K. Arellano, and D. Muñoz-Sarmiento, Intra-lesional injection of betamethasone for the treatment of symptomatic pinguecula. Archivos de la Sociedad Española de Oftalmología (English Edition), 2014. 89 (10): p. 408-410.
[19] Somnath, A. and K. Tripathy, Pinguecula. StatPearls [Internet], 2020.
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    Farhad Nejat, Khosrow Jadidi, Mohammad Amin Nejat, Nazanin-Sadat Nabavi, Seyede-Yasamin Adnani, et al. (2021). A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series. American Journal of Clinical and Experimental Medicine, 9(5), 142-146. https://doi.org/10.11648/j.ajcem.20210905.13

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    ACS Style

    Farhad Nejat; Khosrow Jadidi; Mohammad Amin Nejat; Nazanin-Sadat Nabavi; Seyede-Yasamin Adnani, et al. A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series. Am. J. Clin. Exp. Med. 2021, 9(5), 142-146. doi: 10.11648/j.ajcem.20210905.13

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    AMA Style

    Farhad Nejat, Khosrow Jadidi, Mohammad Amin Nejat, Nazanin-Sadat Nabavi, Seyede-Yasamin Adnani, et al. A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series. Am J Clin Exp Med. 2021;9(5):142-146. doi: 10.11648/j.ajcem.20210905.13

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  • @article{10.11648/j.ajcem.20210905.13,
      author = {Farhad Nejat and Khosrow Jadidi and Mohammad Amin Nejat and Nazanin-Sadat Nabavi and Seyede-Yasamin Adnani and Shima Eghtedari},
      title = {A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {9},
      number = {5},
      pages = {142-146},
      doi = {10.11648/j.ajcem.20210905.13},
      url = {https://doi.org/10.11648/j.ajcem.20210905.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20210905.13},
      abstract = {Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - A Novel Approach to Treatment of Pinguecula Using Atmospheric Low-temperature Plasma: A Clinical Case Series
    AU  - Farhad Nejat
    AU  - Khosrow Jadidi
    AU  - Mohammad Amin Nejat
    AU  - Nazanin-Sadat Nabavi
    AU  - Seyede-Yasamin Adnani
    AU  - Shima Eghtedari
    Y1  - 2021/09/30
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajcem.20210905.13
    DO  - 10.11648/j.ajcem.20210905.13
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 142
    EP  - 146
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20210905.13
    AB  - Background: In recent years plasma medicine, played an important role in treating several ocular surface disorders. This study will introduce atmospheric low-temperature plasma (ALTP) for removing the pinguecula. Methods: In the clinical case series, five eyes of five patients (2 patients OD, 3 patients OS) with pinguecula were included. The pinguecula removed and completely healed, using the white handpiece of the plasma generator device (Plexr, GMV s.r.l Grottaferrata, Italy). Refraction parameters, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (BDVA), intraocular pressure (IOP), corneal fluorescein staining (CFS), contrast sensitivity (CS) and dry eye tests including, tear meniscus height (TMH) and tear breakup time (TBUT) were measured before, one month and six months after treatment for all patients. Results: The median size of the pinguecula was 3.5 mm (ranged from 2.5 to 4.5 mm). In all patients, the pinguecula was completely sublimated and after six months of follow-up, no evidence of recurrence was observed. In addition, the patient follow-up did not reveal any considerable complications during or 6 months after the surgery. Conclusion: Overall, the current study showed that, plasma assisted noninvasive surgery (PANIS method) is a simple, office-based, minimally invasive, effective approach to treat pinguecula with no considerable complications but it is noteworthy that, study with higher sample size like clinical trial is needed.
    VL  - 9
    IS  - 5
    ER  - 

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Author Information
  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

  • Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

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