Astigmatic changes following pterygium removal: Comparison of 5 different methods

Abstract

Aims:To investigate the effect of surgery type on the postoperative astigmatism in pterygium surgery.Settings and Design:Retrospective comparative clinical trial.Materials and Methods:Data of 240 eyes that underwent pterygium excision were investigated. Following removal of the pterygium, patients underwent 5 different types of surgeries: Conjunctival autograft with sutures (CAG-s) or fibrin glue (CAG-g), conjunctival rotational flap (CRF), or amniotic membrane transplantation with either suture (AMT-s) or with glue (AMT-g). The preoperative and postoperative keratometric measurements, evaluated using an automated keratorefractometer, were noted.Statistical Analysis:The overall changes in BCVA and astigmatic degree were evaluated using Wilcoxon signed rank test. The difference in astigmatic values between groups was calculated using one way analysis of variance (ANOVA).Results:The most commonly performed procedure was CAG-s (N = 115), followed by CAG-g (N = 53), CRF (N = 47), AMT-s (N = 15), and AMT-g (N = 10). Following surgery, astigmatic values decreased from 3.47 ± 2.50 D to 1.29 ± 1.07 D (P < 0.001, paired t test). The changes in astigmatism was significantly related to the preoperative size of the pterygium (ρ = 3.464, P = 0.005). The postoperative astigmatism correlated with preoperative astigmatism (ρ = 0.351, P < 0.001, Spearman correlation analysis). The changes in astigmatic values was not related to the method of surgery (P = 0.055, ANOVA).Conclusion:Pterygium results in high corneal astigmatism, which decreases to an acceptable level following excision. According to our study, the type of grafting as CAG, CRF or AMT or the use of suture or glue to fixate the graft does not have a significant effect on the change in astigmatism degree.

Recurrence rate and corneal astigmatism after ‘sliding flap’ technique with intraoperative application of 0.05% mitomycin C or 20% ethanol for pterygium surgery

“…In both groups, there was a visible but statistically insignificant reduction of corneal astigmatism compared to the preoperative measurement (MMC group before the surgery: 1.2 ± 0.8 Dcyl, 12 months postoperatively: 0.9 ± 0.7 Dcyl; ALC group before the surgery: 1.3 ± 1.3 Dycl, 12 months postoperatively: 0.8 ± 0.6 Dcyl). Previous studies' results indicate that after pterygium surgery there is a significant reduction of corneal astigmatism regardless of the surgical technique used (31)(32)(33). Up today, no research investigated corneal astigmatism after the 'sliding flap' technique with adjunctive MMC or ethanol.…”

Changes in corneal astigmatism following pterygium surgery – comparison of 3 different surgical techniques

“…Dotychczas w licznych doniesieniach analizowano wyniki różnych typów operacji oraz nawrotów (3), w mniej licznych badaniach porównywano wpływ metod chirurgicznych na wielkość pooperacyjnego astygmatyzmu (4).…”

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“…2 In the treatment, several different surgeries are being performed to decrease the high recurrence of bare sclera technique, such as conjunctival autografting and amniotic membrane grafting. 3 In the present study, we aimed to evaluate the effect of pterygium size on corneal astigmatism before and after pterygium excision surgery with amniotic membrane grafting; and the benefits and safety of amniotic membrane grafting in pterygium surgery.…”