Comparison of Recurrence Rate in Excision of Conjunctival Rhinosporidiosis Mass with and without Cauterization of Base: A Randomized Clinical Trial

Main Article Content

Suchita Singh
Prabha Sonwani
M. Shrivastava

Abstract

Aim: To compare the recurrence rate of conjunctival rhinosporidiosis mass excision, with and without cauterization of base.

Study Design: Prospective randomized clinical trial.

Place and Duration of Study: Department of Ophthalmology, CIMS, Bilaspur (C.G), India. (Feb 2018-Dec 2019)

Methodology: Twenty patients (5-25years) who presented with conjunctival mass clinically diagnosed as ocular rhinosporidiosis were included in this study. Patients were recruited from OPD ophthalmology CIMS, Bilaspur (C.G). Patients were divided on alternate basis into two groups.  Each group had 10 patients. Group1 included excisions with cauterization of base with wet field cautery and group 2 included excisions without cautery. All the procedures and post-operative evaluation were done by the same surgeon. These two groups were compared for recurrence of mass at the same site and other sites. Post-operative evaluation was done at 1 week, 1 month, 3 months and 6 months.

Results: Patients’ age ranged between 5-15 years were more in both groups. There were more males than females and majority of them lived in rural areas where pond water was the only accessible portable water. Lower lid palpebral conjunctiva was more involved. The mean duration of lesion was similar in both groups. All the patients were examined at 1 week, 1 month, 3 months and 6 months post-operatively, to check for recurrence at the same site by the same surgeon. The ear, nose and throat was examined by an otolaryngologist. No recurrence was found after 6 months of the procedure at ocular and extra-ocular sites.

Conclusion: Our study concludes that in cases of rhinosporidiosis mass of palpebral conjunctiva, total excision of mass without cauterization of base is as effective as with cauterization of base.

Keywords:
Conjunctival rhinosporidiosis, strawberry like lesion, surgical excision, Rhinosporidium seeberii

Article Details

How to Cite
Singh, S., Sonwani, P., & Shrivastava, M. (2020). Comparison of Recurrence Rate in Excision of Conjunctival Rhinosporidiosis Mass with and without Cauterization of Base: A Randomized Clinical Trial. Ophthalmology Research: An International Journal, 13(3), 13-19. https://doi.org/10.9734/or/2020/v13i330168
Section
Original Research Article

References

Arseculeratne SN. Rhinosporidiosis: what is the cause? Current Opinion in Infectious Diseases. 2005;18(2):113-118.

DOI:10.1097/01.qco.0000160898.82115.e8

Das S, Kashyap B, Barua M, et al. Nasal rhinosporidiosis in humans: New interpretations and a review of the literature of this enigmatic disease. Med Mycol. 2011;49(3):311-315.

DOI: 10.3109/13693786.2010.526640

Moses JS, Balachandran C, Sandhanam S, et al. Ocular rhinosporidiosis in Tamil Nadu, India. Mycopathologia. 1990;111:5-8.

Available:https://doi.org/10.1007/BF02277293

Chowdhury RK, Behera S, Bhuyan D, Das G. Oculosporidiosis in a tertiary care hospital of western Orissa, India: A case series. Indian J Ophthalmol. 2007;55:299-301.

Herr RA, Ajello L, Taylor JW, Arseculeratne SN, Mendoza L. Phylogenetic analysis of Rhinosporidium seeberi's 18S small-subunit ribosomal DNA groups this pathogen among members of the protoctistan Mesomycetozoa clade. J Clin Microbiol. 1999;37(9):2750-2754.

DOI: 10.1128/JCM.37.9.2750-2754.1999

Fredricks DN, Jolley JA, Lepp PW, et al. Rhinosporidium seeberi: A human pathogen from a novel group of aquatic protistan parasites. Emerging Infectious Diseases. 2000;6(3):273- 282.

DOI: 10.3201/eid0603.000307

Mendoza L, Taylor JW, Ajello L. The class mesomycetozoea: A heterogeneous group of microorganisms at the animal-fungal boundary. Annu Rev Microbiol. 2002;56: 315-344.

DOI:10.1146/annurev.micro.56.012302.160950

Arseculeratne SN, Sumathipala S, Eriyagama NB. Patterns of rhinosporidiosis in Sri Lanka: Comparison with international data. Southeast Asian J Trop Med Public Health. 2010;41(1):175-191.

Ashworth JH. On Rhinosporidium seeberi (Wernicke, 1903) with special reference to its sporulation and affinities.Trans R Soc Edinburgh. 1923;53:302-342.

Karunaratne WAE. Rhinosporidiosis in man. The Athlone Press, London, England; 1964.

Kaye H. A case of rhinosporidiosis on the eye. Br J Ophthalmol. 1938;22(8):449-455.

DOI: 10.1136/bjo.22.8.449

Sudarshan V, Goel NK, Gahine R, Krishnani C. Rhinosporidiosis in Raipur, Chhattisgarh: A report of 462 cases. Indian J Pathol Microbiol. 2007;50(4):718-721.

Duke-Elder S: Diseases of the Outer Eye. 1965, St. Louis: Mosby, III

Black EH, Nesi FA, Gladstone G, Levine MR, Calvano CJ. (Eds). vSmith and Nesi’S Ophthalmic Plastic and Reconstructive Surgery.

Mukhopadhyay S., Shome S, Bar PK, et al. Ocular rhinosporidiosis presenting as recurrent chalazion. Int Ophthalmol. 2015;35:705–707.

Available:https://doi.org/10.1007/s10792-012-9625-2

Mithal C, Agarwal P, Mithal N. Ocular and adnexal rhinosporidiosis: The clinical profile and treatment outcomes in a tertiary eye care centre. Nepal J Ophthalmol. 2012;4(1):45-48.

DOI: 10.3126/nepjoph.v4i1.5849

Gichuhi S, Onyuma T, Macharia E, et al. Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya – A case report. BMC Ophthalmol. 2014;14:45.

Available:https://doi.org/10.1186/1471-2415-14-45

Nair AG, Ali MJ, Kaliki S, Naik MN. Rhinosporidiosis of the tarsal conjunctiva. Indian J Ophthalmol. 2015;63:462-3.

Kanika Jain, Taru Dewan, Purnima Paliwal, Manav Deep Singh, Sonali GuptaOcular Rhinosporidiosis Presenting As a Rapidly Growing Conjunctival Papilloma. DJO. 2018;28:32-34.