scholarly journals Keratometric changes after pterygium excision

Author(s):  
Sharda Punjabi ◽  
Appurv Kachhwaha

Background: A pterygium is a wing-shaped growth of conjunctiva and fibrovascular tissue on the superficial cornea. The pathogenesis of pterygia is strongly correlated with UV light exposure and environmental factors. The prevalence of pterygia increases steadily with proximity to the equator, and the condition is more common in men than women. It is well established fact that before entering the optical zone pterygium causes flattening of the cornea in horizontal meridian with the more normal side of the cornea usually temporally, resulting in with-the-rule astigmatism.Methods: The study included 80 patients of primary pterygium who underwent pterygium excision with conjunctival autograft adhered by autologous blood surgery. After performing routine ocular examination which includes visual acuity without and with pinhole and pre-operative keratomery was assessed by autokeratorefractometer. Repeat examination was performed after 6 weeks of surgery. Patients with recurrent pterygium, pseudo-pterygium, and history of previous ocular surgery were excluded.Results: The pre‑ and postoperative corneal astigmatism were compared after 6 weeks of surgery. The changes in corneal astigmatism were statistically significant p value <0.001. The preoperative mean corneal astigmatism of 3.41 D was reduced to 1.59 D (p value <0.001) 6 weeks after surgery, but maximum change in astigmatism was seen in Grade IV >Grade III >Grade II >Grade I.Conclusions: Primary pterygium of all grades treated with well accepted technique pterygium excision with conjunctival autograft with autologous blood gives promising results in terms of improvement in corneal astigmatism and hence visual acuity as well.

2021 ◽  
pp. 21-23
Author(s):  
Kumari Preeti ◽  
Nitu Kumari ◽  
[Prof.] Alka Jha ◽  
Debarshi Jana

Objectives: The aim of this study was to assess if there is any signicant reduction in astigmatism and thus improvement in visual acuity after pterygium excision with limbal stem cell grafting. Methods: In this prospective study, patients with primary pterygium were included. Preoperative and postoperative corneal astigmatism, refractive astigmatism and visual acuity were analyzed. All patients underwent pterygium excision with limbal stem cell grafting. Results: Mean improvement in visual acuity of 0.09 log MAR units was observed (p <0.0001, statistically signicant).Mean corneal astigmatism for grade I, II and III was found to be 1.03 ± 0.68D, 1.69 ± 0.80D and 2.90 ± 1.06D respectively. Mean corneal astigmatism decreased by 1.29 D (p <0.0001, statistically signicant).A decrease of 0.77D in cylindrical power required was found after surgery (p <0.0001, statistically signicant). Conclusions: there is a signicant reduction in pterygium induced astigmatism and improvement in visual acuity on surgical removal of the pterygium.


2020 ◽  
Vol 9 (2) ◽  
pp. 1-4
Author(s):  
Madhavi Chevuturu

Background: Pterygium causes visual problems due to induced corneal astigmatism or direct encroachment onto the visual axis. The present study was conducted to compare preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Subjects and Methods: The present study was conducted from May 2018 to August 20018 on 69 patients of age range 20-55 years of primary Pterygium. Patients were divided into three groups of 23 each. Group I was treated with bare sclera (BS) technique, Group II with conjunctival autograft (CAG) technique and Group III with amniotic membrane graft (AMG) technique. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were recalled on day 5, 1 month, and 3 months for the analysis. Results: Uncorrected visual acuity (UCVA) preoperatively was 0.57, on the 5th day was 0.45 after 1 month was and after 3 months was 35. The mean preoperative astigmatism value in group I was 3.45, in group II was 3.52 and in group III was 3.49. Postoperative astigmatism value in group I was 1.60, in group II was 0.92 and in group III was 0.81. The difference was significant (P< 0.05). Conclusion: Authors found that amniotic membrane graft and a conjunctival autograft is better surgical techniques than bare sclera in reducing astigmatism.


2020 ◽  
Vol 9 (1) ◽  
pp. 25-30
Author(s):  
Dikchhya Sharma ◽  
Gunjan Prasai ◽  
Om Krishna Malla

Background: Pterygium induces a significant amount of astigmatism. Pterygium excision with conjunctival limbal autograft results in significant reduction in astigmatism by inducing a reversal of pterygium induced corneal flattening thereby improving the vision. Objectives: The aim of this study was to investigate the amount of corneal astigmatism in patients with pterygium before and one month (4 weeks) after surgery.  Methodology: The prospective observational study was conducted in 31 patients who underwent pterygium excision with limbal autograft in Kathmandu Medical College Teaching Hospital during the study period of 12 months duration. Patients with recurrent pterygium, pseudopterygium, history of ocular trauma, history of ocular surgery, corneal scarring were excluded from the study. After surgery, patients were followed for four weeks. Findings were recorded in the proforma and statistical analysis was done in SPSS version 19.   Results: Pterygium was seen in all age groups with majority being in the active age range of 41-50 yrs. Females were most commonly affected. Significant difference in corneal astigmatism was noted postoperatively with a p value being 0.01. Conclusion: The technique of pterygium excision with limbal conjunctival autograft not only reduces the chances of recurrence but also helps in reducing the induced corneal astigmatism which is responsible for decreased vision in patients with pterygium.


2015 ◽  
Vol 56 (6) ◽  
pp. 856 ◽  
Author(s):  
Dong Ik Kim ◽  
Mee Kum Kim ◽  
Won Ryang Wee ◽  
Joo Youn Oh

2021 ◽  
Vol 28 (04) ◽  
pp. 568-571
Author(s):  
Saira Bano ◽  
Sumaya Khan ◽  
Mahnoor Waqar ◽  
Moniba Iqbal ◽  
Hamza Waqar Bhatti ◽  
...  

Objective: To determine the difference in mean corneal curvatures before and after pterygium excision. Study Design: Quasi-experimental study. Setting: Department of Ophthalmology, Holy Family Hospital, Rawalpindi. Period: 1st January 2015 to 1st July 2015. Material & Methods: 68 patients aged between 18 to 65 years were included in the study. Patients with history of ocular trauma, ocular surgery, glaucoma, anti-glaucoma treatment, allergy to steroids, pseudo pterygium, recurrent pterygium and presence of corneal abnormalities such as, scarring that might affect the astigmatic value were excluded. All patients underwent comprehensive ophthalmic examination by slit lamp and best corrected visual acuity and keratometric values were noted. Pterygium excision was done by a single surgeon. BCVA and keratometric readings were taken again after 2 weeks of pterygium excision. Results: Mean age was 37.60 ± 11.11 years. Out of these 68 patients, 44 (64.71%) were male and 24 (35.29%) were females. Mean pre-operative corneal curvature was 2.99 ± 0.69D and post-operative corneal curvature was 1.70 ± 0.40D with P-value of <0.0001 which is statistically significant. Conclusion: This study concluded that pterygium excision brings significant change in corneal curvature in patients of pterygium induced astigmatism.


2020 ◽  
Author(s):  
ASHOK JHA ◽  
Abhay Simba

Abstract Background: To compare conjunctival autograft and combined amniotic membrane mini-simple limbal epithelial transplant after primary pterygium excision Methods: A prospective randomized interventional study was conducted on 264 eyes with Primary Pterygium.The patients were divided into Group I (conjunctival autograft) and Group II (mini-simple limbal epithelial transplant). 133 eyes in Group I underwent pterygium excision with a conjunctival autograft using fibrin glue. 131 eyes in Group II underwent mini Simple Limbal Epithelial Transplant with amniotic membrane using fibrin glue. Post-operatively, the patients were reviewed on day 1,3,7,14 & 30 and then at three,six and nine months. Primary outcome measure was the recurrence rate whereas the secondary outcome measures were the intraoperative time and other complications.Recurrence rate was calculated using Fisher’s exact test. Variables like age , preoperative BCVA , operative time and the dimensions of graft were compared using unpaired t test . Other baseline characteristics like gender, Laterality, grades of pterygium(I-III),Occupation and indication of surgery were expressed between the two groups using Pearson’s Chi-Square test. Results: Two hundred and thirty three eyes(118 in group I and 115 in group II) could complete nine months follow-up period. Recurrence was seen in 2(1.6%) cases in group I whereas 3 cases (2.6%) had recurrence in group II(p=0.681).Operative time for group (II) (20.33±1.28 min) was significantly higher (p<0.001) than group I (12.01±1.26). Graft displacement occurred in one case in group II (p=0.999). Conclusions: Despite a longer time,(p<0.001) mini-SLET seems to be a viable and equally effective alternative to CAG in the management of primary pterygium ,especially in cases where conjunctiva needs to be spared.Ethical Clearance Certificate Number : 29/MH/2015 dated 11 Aug 2015


2018 ◽  
Vol 3 (2) ◽  
pp. 1-7
Author(s):  
Dr. Keerthivarman Rukmangathan ◽  
◽  
Dr. Dhivya Ramakrishnan ◽  
Dr. Vasudarini Sundararajan ◽  
Dr. Ranjan Chandrasekaran ◽  
...  

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