Earlier Corneal Topographical Changes After Different Pterygium Surgical Techniques: a Comparative Pentacam Scheimpflug Imaging Study

Abstract

Purpose: To investigate earlier corneal topographical changes and visual acuity after different pterygium surgical techniques using the Pentacam Scheimpflug imaging system.Methods: This study enrolled 98 patients with unilateral primary nasal pterygium. Pterygium surgery with either a conjunctival autograft (group 1) or an anchored conjunctival rotational flap (group 2), with fibrin tissue adhesive was performed under topical anesthesia. Baseline and one-month post-operative best-corrected visual acuity (BCVA) in logarithm of the Minimum Angle of Resolution (logMAR) and anterior corneal astigmatism (ACA), flat keratometry (Kf), steep keratometry (Ks) and posterior corneal astigmatism (PCA) were analyzed.Results: Mean BCVA improved from baseline 0.119±0.113 to 0.082±0.086 logMAR in group 1, and from baseline 0.169±0.128 to 0.120±0.121 logMAR in group 2. There were no statistically significant differences between the two groups in pre-and post-operative ACA, PCA, Kf and Ks. (p=0.686; 0.9020.107; and 0.592, respectively). Intra-group analysis revealed statistically significant differences in both groups: ACA (p<0.001 for both groups), with a greater difference in group 1 (2.072), and Kf (p<0.001 for both groups), with a slightly greater change in group 2 (1.910). While there were no statistically significant Ks intra-group differences in both groups (group 1: p=0.091; group 2: 0.092), group 1 (0.0522) displayed more Ks changes. There were also no statistically significant intra-group PCA differences in both groups (p=0.061 for both groups). However, Group 2 (-0.020) displayed greater changes.Conclusions: Significantly improved anterior corneal topographical changes highly associated with conjunctival autografting. However, the conjunctival rotational flap was associated with relatively greater posterior corneal topographical changes.