Abstract
Abstract
Introduction: A pterygium is a fibrovascular growth that extends from the conjunctiva to the cornea. It causes tractional forces which result in a flattened cornea, typically causing astigmatism. The study objective was to evaluate the effect of pterygium excision on corneal astigmatism.
Methodology: This was a prospective single arm cohort study which was conducted at the University Teaching Hospital from May 2024 to March 2025. A total of 46 participants were recruited yielding 48 eyes with primary pterygium. Adult pterygium patients ≥18 years were evaluated before surgery and at 2 and 6 weeks postoperatively for best corrected visual acuity, keratometry, and refractive astigmatism.
Results: Of the 48 eyes recruited, one eye was excluded due to loss to follow, hence 47 eyes were analysed. The mean age of the participants was 47.85 years, with the oldest and youngest participants aged 74 and 24 years, respectively. The results revealed best corrected visual acuity (BCVA) improved from 0.27±0.25 before surgery to 0.19±0.15 (p<0.001) and 0.14±0.12 (p<0.001) at 2- and 6-weeks post-surgery, respectively. The mean corneal astigmatism was 2.62±2.75D preoperatively. The mean corneal astigmatism at 2 and 6 weeks was 0.47±1.10 and 0.01±0.50D at 6 weeks post-operation. Significant differences in BCVA and astigmatism were maintained even between the 2 and 6 week post-operatively.
Conclusion: Pterygium excision with autograft leads to a significant reduction in astigmatism and improvement in BCVA. Stability in BCVA and astigmatism was not established by week 2 postoperative follow up, highlighting the need for further follow-up assessments.
Key words: Best Corrected Visual Acuity, Keratometry readings
References
Raj, A, Dhasmana, R, Bahadur H. (2021), Morphometric evaluation and measurements of primary pterygium by anterior segment optical coherence tomography and its relation with astigmatism, Therapeutic advances in ophthalmology. doi: 10.1177/25158414211020145.
Rezvan et al. (2018), Prevalence and risk factors of pterygium: a systematic review and meta-analysis, Pubmed https://pubmed.ncbi.nlm.nih.gov/29551597/
Murube, J. (2008), Pterygium: descriptive nomenclature of the past. Googlescholar 10.1016/S1542-0124(12)70278-1
Shahraki T, Arabi A, Feizi S. (2021) Ptergium: an update on pathophysiology, clinical features and management, Therapeutic advances in ophthalmology. https://doi.org/10.1177/25158414211020152
Pesudovs, K, Figueiredo, F.C. (2006), Corneal first surface wavefront aberrations before and after pterygium surgery, Journal of Refractive Surgey, journals.healio.com. https://doi.org/10.3928/1081-597x-20061101-17
Amoah, K, et al. (2022), Changes in Astigmatism and Visual acuity after pterygium excision in Ashanti Region Ghana, Annals of African Surgery. https://doi.org/10.4314/aas.v19i2.5
Sarkar, P and Tripany, K. (2023), Pterygium ,StartPeals Publishing LLC. Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK558907
Kaufman, et al. (2013), Options and Adjuvants in Surgery for Pterygium. A Report by the American Academy of Ophthalmology. Pubmed https://doi.org/10.1016/j.ophtha.2012.06.066
Kheirkhah A, et al., (2012) Effects of pterygium surgery on the front and back of corneal surfaces and anterior segment parameters. Int ophthalmol. https://doi.org/10.1007/s10792-012-9560-2
Hilmi MR, Kamal KM, Azemin, (2020), Pterygium recurrence and stabilization point after pterygium excision, Makara journal health press ;14: 140- 46. 10.7454/msk.v24i2.1195
Korchak M, Cremers SL, Ha J, Koppinger J, Martinez JA, (2016), Tracking changes in corneal topography after pterygium excision to aid planning future refractive surgery, IOVS journal. https://iovs.arvojournals.org/article.aspx?articleid=2557761
Akrit, G, et al. (2021), Changes in corneal curvature and visual acuity in North Indian adults after pterygium excision with modified sutureless, glueless limbal-conjunctival autograft, Indian journal of ophthalmology, 69(9):p 2401-2405. https://doi.org/10.4103/ijo.ijo_2747_20
Niruthisard, D, et al. (2021), Time to Keratometric Stability After pterygium excision and the associated factors: A clinical perspective, Clinical ophthalmology. https://doi.org/10.2147/OPTH.S303936
Kumah DB, Oteng A, Harriette A, (2011), Prevalence of pterygium among kitchen staff in senior high schools in the Kumasi metropolis, Ghana., Journal of Ghana science association;11:83-86. https://ghanascience.gov.gh/wp-content/uploads/2018/04/83-88-Kumah.pdf
Kumar M, Farooq S, Khan NA. Kochar A, Sunda P, (2023), Study of morphometric changes of cornea in cases of pterygium, International Journal of community medicine and public health;12:4694-98.
Zheleva, V, Voynov, L. (2018), Comparative study of astigmatic changes following pterygium excision with conjunctival autograft transplantation, Biotechnology & Biotechnological Equipment
Misra S, Craig JP, McGhee C, et al. (2014), A prospective study of pterygium excision and conjunctival autograft with human fibrin tissue adhesive: effects on vision, refraction and corneal topography. Asia Pac J Ophthalmol (Phila). ;3(4):202–206.Review and meta-analysis. BMJ Open; 3: e003787
Yoon CH, Seol BR, Choi HJ. (2023), Effect of pterygium on corneal astigmatism, irregularity and higher-order aberrations: a comparative study with normal fellow eyes. Sci Rep.;13(1):7328. doi: 10.1038/s41598-023-34466-4.
Kam K.W, et al. (2017), Long-term stability of keratometry, scheimpflug-derived true net power, and total corneal refractive power after primary pterygium excision. Cornea.; 36(11), 1358-63. https://doi.org/10.1097/ico.0000000000001341
