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

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.