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MF Pingree, V Mootha; Pterygium with Underlying Endothelial and Descemet's Membrane Changes . Invest. Ophthalmol. Vis. Sci. 2002;43(13):126.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report a series of patients with pterygium associated with changes at the level of the endothelium and Descemet's membrane previously never reported. Methods: Clinical presentations of 6 patients (7 eyes) with pterygium and underlying endothelial changes were reviewed for age, duration of pterygium, size of pterygium, and location of pterygium. Slit lamp photos were obtained. Central corneal pachymetry and specular microscopy were performed on both eyes of all 6 patients. Results: All patients were elderly (age range 64-91) with long standing nasal pterygia (average duration 41 years). The size of the pterygium without previous surgery was 2.0 mm. The average size of the recurrent pterygium after surgery was 2.5 mm (range of 1.0-4.25mm). Slit lamp photos document dots and line marks at the level of the endothelium and Descemet's membrane. All the deep corneal changes were underlying or directly adjacent to the pterygium. Pachymetry measurements of the central cornea averaged 524 microns (range 469-586). Central endothelial cell counts of the seven eyes with apparent endothelial changes averaged 1626 cells/mm2 with a range of 928-1872. The five fellow eyes averaged 1777 cells/mm2 (range 927-2331). Conclusions: The common belief that pterygia do not affect the structures of the cornea beneath Bowman's layer may not be true in some longstanding cases. The peripheral location of the endothelial/Descemet's membrane changes are more consistent with a corneal degeneration rather than a dystrophy. Also, there was no evidence of corneal decompensation by clinical examination or corneal pachymetry. A type of deep corneal degeneration associated with pterygia can rarely occur in longstanding cases.
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