Topographic Changes Before and After Pterygium Surgery

Abstract

Background: Pterygium characterized by a centripetal growth of fibrovascular tissue associated with inflammation and vascularization. Corneal astigmatism in an eye with pterygium may reflect the cumulative effect of a naturally occurring astigmatism and that induced by the pterygium. Pterygium surgery usually affects topographic changes associated with pterygium.The aim of the work: This study aimed to detect the topographic changes that occur before and after pterygium surgery using the bare sclera technique.Patients and Methods: This study is prospective, interventional, and non-randomized. It was held at Al-Zahraa University Hospital. It included 20 eyes of 17 patients with primary nasal pterygium. Their age ranged between 23 and 72 years. Pterygium was graded according to its size, extent of corneal involvement and visibility of the underlying episcleral blood vessels. All cases were operated with the bare sclera technique. Follow-up was done after one day, one week, one month, and three months postoperatively.Results: There was a significant improvement of uncorrected and best correct visual acuity at one and three months after surgery. After excision of smaller sized pterygium, the UCVA and BCVA are more improved as compared to excision of larger sized pterygium. The astigmatic value significantly decreased during the first week and third months postoperatively. Sim K2 was significantly increased during the first week and first month after pterygium surgery. Recurrence was reported in 7 out of 20 eyes. Two eyes experienced pyogenic granuloma on the first month of follow-up, while dryness was encountered in 8 eyes.Conclusion: Pterygium excision with bare sclera technique is associated with improvement in UCVA and BCVA, decrease in astigmatic values, and improvement in corneal aberrations. It is associated with a 35% recurrence rate. It is preferable to excise pterygium before reaching 3 mm to avoid visual impairment in late cases.

Keywords

• pterygium
• keratometric readings
• astigmatism
• corneal topography
• visual acuity