La chirurgie géométrique : une nouvelle technique pour traiter le PTERYGION (A propos de 30 cas)

A Pterygium is defined as a fibrovasculaire growth in triangle, which develops from the bulbar conjunctive to pervade the cornea. It is a relatively frequent ocular pathology which predominates in the hot and fry regions, in the north and in the south of Equator. The role of the UV rays is kept as the physio-pathogenic major responsible factor of the genesis of the Pterygium. His only remedial treatment is surgical. Many surgical techniques were described, but none is perfectly efficient. The repetition is main post-operator complication. The team of ophthalmology of the Military Teaching Hospital of Moulay Ismail in Meknes worked on a new surgical technology to treat the Pterygium: Geometric technology. It is about a prospective and comparative study. She analyses a set of 30 cases of Pterygium operated for the technology of geometric surgery, by the same surgeon, during a period between February 2013 and February 2014. All Pterygiums are primary, of levels according to the classification of Vaniscotte. Post-operator controls were accomplished to Day+1, Day+3 months, Day+ 6 months, Day+ 12 months and Day+ 18 months. This study has as objective: the perfecting on this new technology to support surgical procedure, to assess the rate of success, to study possible complications and to compare all these parameters with those of Autograft Conjunctival surgery: reference technology. The medium age of our patients at the time of the surgical taking care is of 55 years, with extremes from ages of 24 years to 80 years. A net masculine predominance is so noted, with a sex-ratio of 5. The anesthetic protocol based on the Xylocaine frost 2 % and the Oxybuprocaine 0,4 % in schema is sufficient to accomplish this surgery, what helps to preserve the original form of Pterygium for a better estimate of geometric cutting up and contributes to the benefit of 40 % of surgical time (the medium length of intervention is of 12 minutes). Post-operator precocious continuation in the course of the 1 st month is favorable in 73 % of the cases, they show fewer annoyance, less prickle than with the technology of autograft. The evaluation of the conjunctival surface shows a favorable aspect in 83 % of the cases and this towards the 3rd month in postoperator. The valuation of surgical result reveals a rate of repetition, which goes up to that of conjunctival autograft (rate of repetition between 2 % and 39 %); in our set, it is 13, 32 %. This very encouraging rate is listed after a post-operator detachment of one year in 70 % of cases. This surgical technology brings new elements in comparison with the ancient techniques. She can be an additional and very promising surgical alternative, which is certainly worth being assessed on a big set with a big detachment.