A Decrease font size. National Library of Medicine Direct injury to the lateral rectus muscle during pterygium surgery is extremely rare. If the surgeon is performing a muscle resection, he or she removes a section of the muscle to shorten it. Special Focus, Ocular Surface and Cornea, Original Article, Diagram of the surgical procedure. You might have diplopia in one eye or both. This retrospective study divided 193 cases of pterygium into the primary (140 cases) and recurrent (53 cases) pterygium groups. and transmitted securely. WebWhen a pterygium does not respond to eye drops, or if it causes vision problems, pterygium excision surgery can be a helpful treatment method. Opens in a new window. J Pediatr Ophthalmol Strabismus. Given this fact, surgery plus proper preventive care will need to be followed to slow the reappearance of a pterygium. Thanks to him I finally have the body I deserve. The survival rate after sliding transposition conjunctival flap was better than conjunctival autograft, because the transposition flap has the conjunctival feeding vessels from noncutting conjunctival surface. Special care should be taken to completely excise the tenon tissue under the free edges of the conjunctiva as this is the source of fibroblastic proliferation leading to pterygial recurrence. They are more like to develop on the side of the eye close to the nose. The site is secure. Any problem that affects one or more of the muscles around the eyeball that control the direction of the gaze can cause binocular diplopia. After surgery it is prudent to always wear wraparound frame sunglasses outdoors. Jasons expertise in the field was unparalleled. Do I need to have macular pucker surgery if it is not severe? In some susceptible patients, the pterygium can grow over the entire corneal surface, blocking the visual axis.Surgery is the only effective treatment for pterygium, though recurrences are common. modify the keyword list to augment your search. After surgical excision, the bare sclera was placed with a tight fit limbal conjunctival autograft fixed via the modified sutureless and glue-free method in group 1 (26 eyes) and conventional sutures in group 2 (26 eyes). Im Carlos Sanchezo from Fort Brooklyn, NY. It could be that your cornea in that eye is uneven. Ive worked with several of personal trainers before and by far Jason is the best Personal Trainer.Through following his rigorous nutritional plan and exercise regime, I was able to achieve a competition ready body in less than 8 weeks.I completed his Total body makeover program that requires functional training and total body movements. The main symptom of surfer's eye, or pterygium (pronounced tur-IJ-ee-um), is a growth of pink, fleshy tissue on the conjunctiva, the clear tissue that lines your eyelids and covers your eyeball. Damage can be from: Lens. Injections of botulinum toxin (Botox) can weaken strong eye muscles opposite the weakened one to help balance vision. However, no significant complications such as symblepharon or delayed wound healing of the cornea and conjunctival surfaces were observed after the operation. There will be some blurring of vision in the operated eye, and possibly double vision with both eyes opendo not drive until this clears up. "Prior to LASIK, I had to wear contact lenses or glasses and it was difficult to perform in the sports I enjoy like skiing and scuba diving. After pterygium surgery, patients typically return home with an eye patch that may be worn for 24 hours. Move your eyes around the clock from noon to 6 and around to 12 again. Claim Your Discount Pterygium surgery is sometimes accompanied by the use of an anticancer medicine called mitomycin C. Mitomycin C with or without autografting can decrease the risk of recurrence. The margins of the sliding conjunctival flaps were firmly fixed to the sclera surface with nonabsorbed suture material such as prolene 9-0. As a personal trainer I would easily say he is this best. Kenyon KR, Wagoner MD, Hettinger ME Conjunctival autograft transplantation for advanced and, 17. We have 4 locations in the greater Monterey area. Your doctor will use the results of this exam, together with your medical history and additional symptoms, to determine if you need more tests. An Approach to Some Aspects of Strabismus from Ocular and Orbital Trauma. 10 In such cases, retreatment may be needed. We observed a statistically significant difference in pterygium recurrence in women but not in men (P = 0.043, Chi-square test). Every pterigium is different. Especially, when pterygium is larger or recurrent type, this procedure can be easily covered the bare sclera, compared to any transposition conjunctival flap operation. [22] Moreover, as the huge primary or recurrent pterygium were excised, the size of the bare sclera is large not enough to cover with healthy conjunctival tissue using a single sliding conjunctival flap. For more information about pterygium removal surgery and whether or not its right for you, be sure to contact our team of eye care specialists today. Vision correction with glasses will still be an option for individuals with pterygium. The sliding conjunctival flap of transposition was first introduced in the middle and late twentieth century. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Special eyewear, like an eye patch or prism glasses, can ease the effects. Sorry the answer is not simple. All rights reserved. The cornea is the clear, frontal part of the eye.) Thanks so much, I have been scared if I will remain like this, prior to the surgery I use to see clearly, my doctor is surprised I can't see clearly now, I have told him I have confidence I will see clearly again. Alpay A, Uurba SH, Erdoan B Comparing techniques for pterygium surgery Clin Ophthalmol 2009 3 69 74, 25. In most cases, double vision is easy to pinpoint in adults, because they can describe what they are seeing. Children with double vision caused by strabismus can improve with treatment. It is normal for the eye to feel scratchy and irritated in the early days after surgery. NYU Langone Health MyChart or the NYU Langone Health app, If you need help accessing our website, call 855-698-9991. With my busy life style it was hard to find time to hit the gym. The requirement for patient informed consent was waived by the IRB because of the retrospective nature of the study. Vision may become impaired if a pterygium grows over the cornea and covers the pupil, blocking the eyes line of vision or inducing an abnormal shape to the cornea called astigmatism. We retrospectively reviewed the medical records of patients with primary or recurrent pterygia who had undergone excision followed by the use of double-sliding conjunctival transposition flaps between November 2013 and November 2019. Table 2 shows the distribution of recurrent pterygium according to the frequency of recurrence. American Optometric Association: Keratoconus., Merck Manual Consumer Edition: Vision, Double., Harvard Health Publishing: Double Vision (Diplopia)., Nippon Ganka Gakkai Zasshi: Treatment and prognosis of diplopia.. The cap or leading edge is a flat zone on the cornea that consists mainly of fibroblasts that invade and destroy Bowmans membrane. Baixe contedo gratuito e pesquise milhes de imagens, fotos e vetores de qualidade a preos acessveis. MY name is Jason Fiorini i have been among one of the top personal trainers in the financial district in NYC for 10 years. http://www.aoa.org/, American Academy of Ophthalmology You may not resume contact lens wear until at least 4 weeks after surgery, once you have completed If the doctor sees your eyes shift as the eye cover is moved, it means your eyes are not aligned properly. Were others have failed, Jason came through. Hi, My name is Niki. In addition, the recurrences of most pterygium surgery are generally observed within 1 year of pterygium excision, especially within 6 months. Baixe contedo gratuito e pesquise milhes de imagens, fotos e vetores de qualidade a preos acessveis. Take my advice and call him today! Although Hara et al. As with any surgical procedures there are risks. Yanoff, M. Ophthalmology, 2nd edition, Mosby, 2004. Generally over the counter Tylenol is all patients need (together with ice packs) placed over their eyes for 24 hours. Get $1000 off LASIK + $99 per month financing. 2019 Apr 29;56:e34-e37. Before it appears, you might notice a related condition called a pinguecula (pin-GWEK-yoo-la). WebA pterygium consists of three distinct parts: the cap, the head and the body/tail. Pterygium surgery outcomes In most cases a pterygium comes away very cleanly and heals well, leaving only faint scarring on the cornea and with the white of the eye slowly returning to a normal appearance. Data is temporarily unavailable. [17] Although the inhibition of pterygium recurrence by various adjunctive methods may be existed, the recurrence rates of pterygium surgery still range between 11.4% and 60.0%. If weak eye muscles are to blame or if a muscle is pinched because of an injury, surgery may help. Thanks for sharing your experience. I began working with Jason as a New Years resolution and by May I lost 56 lbs.Thanks to Jasons amazing nutritional strategies, innovative exercise programs and cardiovascular routines I was able to achieve the body I always wanted. Exploration during strabismus surgery 4 months later revealed a partially severed lateral rectus muscle and extensive conjunctival scarring. He made loosing 21 lbs easy.After following his nutritional guidelines and personal training routine I achieved the ultimate results. If you are diagnosed with a pterygium, it is likely that your doctor will not recommend any additional treatment and will instead instruct you to monitor the growth and follow up if the pterygium causes redness and inflammation. Founder of Hard Bodies Personal Training in 2009 me and my elite team of upscale professional personal trainers NYC bring a variety of fitness programs for its clients to choose from. I was 100% happy with the results and Ill never do personal training with anyone else again. Yes. Please enable scripts and reload this page. | Designed & Developed by Most helpful. CA 93940, Pterygium Removal: What to Expect from This Eye Surgery, By Monterey County Eye Associates on March 17, 2018, Monterey County Eye Associates Salinas Location, Monterey County Eye Associates King City Location, contact our team of eye care specialists today. That includes overcast days -- clouds dont stop ultraviolet (UV) light. Fitness modeling has always been my life time dream. WebFlashes of light ( Photopsia) are another common symptom. Pterygium Surgery Signs and Symptoms Eye redness and Ophthalmia. International Society of Refractive Surgery. The https:// ensures that you are connecting to the This helps to diagnose the problem and monitor the problem over time. I accomplished my goals in 17 weeks with his in home personal training and nutrition program. However, since there are two separate incisions/procedures per eye, you may try billing the second procedure with modifier -XS Separate structure to Medicare Part B. We use cookies and similar tools to give you the best website experience. The surgeon then reattaches the muscle closer to the back of the eye. After battling my weight for over 20 years, I finally achieved the ultimate weight loss. All rights reserved. It can take several weeks to fully recover from squint surgery. The growth might spread slowly during your life or stop after a certain point. I was diagnosed with Diabetes years ago mostly due to my poor nutrition and lack of exercise. Astigmatism can be associated with double vision and is more associated with larger growths. WebYou can anticipate recovery time to be about a month. http://www.aao.org/. Thus, the bare scleral technique is no longer recommended for pterygial surgical treatment. I had the same procedure in Feb 2022 and as of today March 20th 2022 My left eye is still blurry, its extremely frustrating. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Jan 31, 2022. The mean postoperative follow-up durations were 16.5 15.3 (range, 651) and 8.3 13.0 (range, 648) months. WebAbstract. Salinas, The main surgical technique consisted of complete removal of pterygium and subconjunctival tissue and covering of the conjunctival surface firmly by fixed conjunctivascleraconjunctival suture after excision of primary and recurrent pterygial tissue. They include: If you have double vision, you may also notice: Double vision that's new or doesnt have a clear cause can be serious. [15] Among these, sliding conjunctival flaps can supply better vascular circulation of the conjunctival flaps and accelerate wound healing compared to auto-conjunctival flaps. However, visual acuity, cornea, and total astigmatism improved significantly after surgery in first recurrent group but not in over twice recurrent group. Am J Ophthalmol. WebLook red If the growth gets onto your cornea (the pupil area of your eye ), it could change its shape and cause blurry vision or double vision. The inflammation had subsided and complete re-epithelialization of ocular conjunctival surface occurred within 23 weeks after surgery. Pterygium Surgery Implantable Miniature Telescope Surgery See Your Best This Winter! Thanks to pterygium removal surgery, patients are able to experience a normal eye appearance and improved vision. Glasses can probably fix the problem. Cho JW, Chung SH, Seo KY, Kim EK Conjunctival Mini-flap technique and conjunctival autotransplantation in pterygium surgery J Korean Ophthalmol Soc 2005 46 1471 7, 24. Opens in a new window. They are frequently asymptomatic at first, with many patients complaining of issues related to cosmetic appearance rather than painful or irritating symptoms. Eye specialists may consider other strategies to help improve the eye movements. No significant difference in success rates was observed between these groups (P = 0.533) regardless of the frequency of recurrence in recurrent pterygium. Surgery almost always fixes them. Today, PRK remains safer and more effective for individuals facing certain corneal health issues. Pterygium do not always require treatment, and only in more serious cases is medical intervention or surgical removal recommended. I have never had a problem with my vision. The surgeon makes a small incision in the conjunctiva, the thin layer of tissue that covers the eye muscles. Community Needs Assessment & Service Plan. I really couldnt believe the amount of experience and preparation used in his exercise program.Overall, Jasons personalized health and fitness helped me to achieve my up most goals in weight loss. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Bird Flu Deaths Prompt U.S. to Test Vaccine in Poultry, COVID Treatment in Development Appears Promising, Marriage May Help Keep Your Blood Sugar in Check, Getting Outdoors Might Help You Take Fewer Meds, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox, Lots of exposure to ultraviolet light (like from the sun), Over-the-counter eye ointments or wetting drops, Eyedrops that clear up redness and irritation. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pterygium only rarely requires surgical intervention, and in general they typically do not cause serious symptoms or long-term side effects. Our personal trainers in the Financial District build a one of a kind program for each of their clients. Malla T, Jiang J, Hu Kai Clinical outcome of combined autograft transplantation and amniotic membrane transplantation in pterygium surgery Int J Ophthalmol 2018 11 395 400, 16. To understand how diplopia can happen, it helps to knowthe parts of your eye and how they work together. After surgery, patients are likely to experience pain and discomfort that lasts for a few days. However, 10% will experience age-related vision problems. Hara T, Hashimoto T, Hara T Pterygium surgery using the principle of contact inhibition:Results of 13 years'experience Graefes Arch Clin Exp Ophthalmol 2017 255 583 90, 12. The visual acuity values improved significantly in the primary pterygium group, from logMAR 0.24 preoperatively to logMAR 0.21 postoperative (P = 0.001). If the pterygium is stable and not progressing, observation is recommended. To all the people who are tired of not reaching there fitness goals. The recurrent pterygium group included 53 cases; of the 29 women, four required re-operation after the first operation. Surgery or medicine can treat Graves' disease. Symptoms are tougher to pinpoint in children, who may not be able to explain what is wrong. Im Amanda. 3]. Sometimes a type of glue can be used to fix graft material to the eyes surface. Thus, we tried to use this two sliding conjunctival transposition flaps technique in pterygial surgery. "Prior to LASIK, I had to wear contact lenses or glasses and it was difficult to perform in the sports I enjoy like skiing and scuba diving. While most pterygium surgeries are simple and performed without incident, there is a slight risk of infection, double vision, prolonged redness of the eye, and excessive swelling. Age is another known risk factor, and older individuals are far more likely to have a pterygium compared to their younger counterparts. Personal trainer Financial District offer their clients top notch one on one personal training. Hi, Im Benny from Manhattan,NY. Two patients in the primary pterygium group required re-operation. Patients are typically prescribed a combination of topical steroid and/or antibiotic medication to help with healing, prevent infection and decrease post surgical scarring. When the bare sclera was covered by two advanced sliding conjunctival transposition flaps, it was important to make a fixed suture between the sliding conjunctival flaps and sclera [Video 1]. Demographics play a role in pterygium frequency as well. FOIA Thus, the success rate of recurrent pterygium is generally lower than that of primary pterygium. WebThe double-sliding conjunctival flaps surgery appeared to be a useful method, with a better success rate and lower pterygial recurrence in pterygium surgery. Pterygium recurrence developed in three of 43 cases (7.0%) in the first recurrence group and one of 10 cases (10%) in the second recurrence and later group. You make take steroid eyedrops for several weeks or months. They are more prevalent among people who are out in the sun a lot or live in arid environments. Total astigmatism and success rate of primary pterygium were significantly better than those for recurrent pterygium. In some susceptible patients, the pterygium can grow over the entire corneal surface, blocking the visual axis.Surgery is the only effective treatment for pterygium, though recurrences are common. The clinical outcomes were assessed by a single ophthalmologist. The outlook for double vision depends on its cause. Although surgery also can remove a pterygium, the abnormal growth can come back and eventually become larger than the original. To do this, you will be asked to look at the doctor's finger as he moves it up, down, left and right. WebMD does not provide medical advice, diagnosis or treatment. Can I take Xiidra after cataract surgery? 2018 Nov;115(11):961-966. doi: 10.1007/s00347-018-0784-z. Pterygia occurs on the surface of the eye, originating from the conjunctiva before spreading to the cornea. The pterygium thickness is related to the visibility of the episcleral vessel and is a significant risk factor for recurrence. I am a 37 year old male from Australia. You will need to include the The conjunctival flaps were generally made from the superior or inferior sides of the excised pterygial sites. Windy environments have also been shown to exacerbate this effect. I have always dreamed of becoming a fitness icon. Hara et al. Pterygium is a common fibrovascular degeneration disease featured by a wing-shaped growth of conjunctival tissue over the adjacent cornea, usually on the nasal side.1 Surgery is the primary treatment for pterygium when it invades the corneal area and impairs vision.24 The restoration of corneal topography and the risk of or you just waited and it returned. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Was first introduced in the greater Monterey area training with anyone else again invade... In pterygial surgery conjunctival transposition flaps technique in pterygial surgery extensive conjunctival scarring 6! Muscle closer to the nose anticipate recovery time to hit the gym symptom... 193 cases of pterygium into the primary pterygium were significantly better than those for recurrent pterygium, fotos vetores. To always wear wraparound frame sunglasses outdoors surface with nonabsorbed suture material such as prolene.... Macular pucker surgery if it is not intended for medical advice, or! Remove a pterygium, the recurrences of most pterygium surgery Implantable Miniature Telescope surgery See best. Of pterygium excision, especially within 6 months and improved vision never had problem... Temporarily unavailable this material is provided for educational purposes only and is not intended for medical advice diagnosis. Have also been shown to exacerbate this effect people who are tired of not there... Have been among one of the muscles around the clock from noon to 6 and around to again... Happy with the results and Ill never do personal training with anyone else again,... Thin layer of tissue that covers the eye close to the lateral muscle! Happy with the results and Ill never do personal training life style it was hard to find time to the... Close to the visibility of the retrospective nature of the sliding conjunctival flap of transposition was first introduced in greater. $ 99 per month financing recover from squint surgery with double vision caused by strabismus can improve with.. Cause binocular diplopia my weight for over 20 years, i finally have the body i.... Has always been my life time dream wraparound frame sunglasses outdoors i the. My goals in 17 weeks with his in home personal training still be an for... Eye, originating from the conjunctiva before spreading to the visibility of the 29,. They are more prevalent among people who are tired of not reaching there fitness goals growth. District build a one of a kind program for each of their clients top notch one one. Far more likely to experience pain and discomfort that lasts for a few days always wraparound! The nose have also been shown to exacerbate this effect strong eye opposite. M. Ophthalmology, 2nd edition, Mosby, 2004 of the study are more to! Muscles are to blame or if a muscle resection, he or she removes a section of eye... Progressing, observation is recommended a one of the sliding conjunctival flaps firmly! Help balance vision care will need to have a pterygium compared to their younger.... Direction of the 29 women, four required re-operation of glue can be associated with double depends!, because they can describe what they are more prevalent among people are! The early days after surgery of pterygium into the primary ( 140 cases ) and recurrent 53... Retrospective study divided 193 cases of pterygium excision, especially within 6 months, 10 % experience. A small incision in the early days after surgery it is prudent to always wear wraparound frame sunglasses outdoors a... Fitness icon Hettinger ME conjunctival autograft transplantation for advanced and, 17 cornea that! The this helps to knowthe parts of your eye and how they work together purposes only and not... Fully recover from squint surgery District offer their clients top notch one on one personal training with anyone else.. Can happen, it helps to knowthe parts of your eye and how they work together 2009 3 74... Surgery Clin Ophthalmol 2009 3 69 74, 25 vision caused by strabismus can improve with.., prevent infection and decrease post surgical scarring can anticipate recovery time to hit the gym patients the! This best 8.3 13.0 ( range, 648 ) months offer their clients top one! Conjunctiva, the success rate of recurrent pterygium according to the nose dreamed... Your life or stop after a certain point, 10 % will experience age-related vision.! Only and is more associated with double vision caused by strabismus can with. Rather than painful or irritating symptoms of recurrent pterygium the gaze can cause diplopia... Eye movements eye patch that may be needed than painful or irritating symptoms that affects one or more the... With his in home personal training B Comparing techniques for pterygium surgery are generally observed within 1 of! Be that your cornea in that eye is uneven over their eyes for 24.. Ultimate results is more associated with larger growths cases of pterygium excision, especially within 6.. Of an injury, surgery plus proper preventive care will need double vision after pterygium surgery have macular pucker surgery if is... Ocular conjunctival surface occurred within 23 weeks after surgery closer to the frequency of recurrence ultimate. Is easy to pinpoint in adults, because they can describe what they are.... Muscle to shorten it ):961-966. doi: 10.1007/s00347-018-0784-z dont stop ultraviolet ( UV ) light this.... With glasses will still be an option for individuals with pterygium top notch one on one training. More serious cases is medical intervention or surgical removal recommended environments have also been shown to exacerbate this effect one... Had subsided and complete re-epithelialization of Ocular conjunctival surface occurred within 23 weeks after.! Intervention or surgical removal recommended of strabismus from Ocular and Orbital Trauma a problem with double vision after pterygium surgery vision injury surgery! The eye muscles are to blame or if a muscle is pinched because of the eye, originating from conjunctiva... Search History, and in general they typically do not cause serious symptoms long-term. Consent was waived by the IRB because of the retrospective nature of the eye. 24 hours those for pterygium... Vision problems in addition, the success rate of primary pterygium group required re-operation arid environments District build a of... Patients complaining of issues related to the back of the episcleral vessel and is more associated double... The early days after surgery more likely to have macular pucker surgery if it is prudent to wear!, because they can describe what they are seeing P = 0.043, test., diagnosis or treatment shorten it symblepharon or delayed wound healing of the retrospective nature of the cornea corneal... We tried to use this two sliding conjunctival flap of transposition was first in! And personal training routine i achieved the ultimate results that invade and destroy membrane. Antibiotic medication to help with healing, prevent infection and decrease post surgical scarring pterygia on! An injury, surgery may help weight loss am a 37 year male... Injections of botulinum toxin ( Botox ) can weaken strong eye muscles to! The eyeball that control the direction of the eye. a kind program for each of clients. Still be an option for individuals facing certain corneal Health issues preventive care will need to be a useful,... Thickness double vision after pterygium surgery related to cosmetic appearance rather than painful or irritating symptoms sometimes a type glue! One personal training style it was hard to find time to be a useful method, with better... Are temporarily unavailable individuals facing certain corneal Health issues larger than the Original surgical scarring if is! The muscle to shorten it surgical treatment is all patients need ( together ice... Informed consent was waived by the IRB because of the muscle closer to the visibility of the sliding conjunctival were. Was 100 % happy with the results and Ill never do personal training the... What they are more like to develop on the surface of the eye, originating from the superior or sides. Layer of tissue that covers the eye muscles are to blame or if a muscle is pinched because an! Be associated with larger growths antibiotic medication to help improve the eye movements hit gym! Be followed to slow the reappearance of a pterygium observed after the first operation recovery time to be a method! In children, who may not be able to experience pain and discomfort that for... The middle and late twentieth century medical advice, diagnosis or treatment diagnose the problem and monitor the over... A few days recurrence in women but not in men ( P = 0.043, Chi-square test ) treatment... In women but not in men ( P = 0.043, Chi-square )! Life time dream, retreatment may be worn for 24 hours prevalent among people who tired. That invade and destroy Bowmans membrane personal training can anticipate recovery time to hit the.! Is prudent to always wear wraparound frame sunglasses outdoors and in general they typically do always. The greater Monterey area my poor nutrition and lack of exercise Hettinger ME conjunctival autograft transplantation advanced! Are likely to experience a normal eye appearance and improved vision to shorten it 10. Slowly during your life or stop after a certain point of three distinct parts: the or... Progressing, observation is recommended be able to explain what is wrong ) light the recurrent pterygium cap, abnormal! Weeks with his in home personal training with anyone else again the visibility of the conjunctival. Personal trainer Financial District build a one of a pterygium compared to their younger counterparts be used fix! Frequency of recurrence to feel scratchy and irritated in the conjunctiva, the recurrences of most pterygium surgery, are. Lack of exercise nature of the muscles around the double vision after pterygium surgery that control the direction of the cornea the. Trainer i would easily say he is this best Monterey area be worn 24. Around to 12 again Telescope surgery See your best this Winter you make take steroid eyedrops for several weeks fully... The muscles around the eyeball that control the direction of the surgical procedure surgery... Complications such as prolene 9-0 ) pterygium groups battling my weight for over 20 years, finally...

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