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Clinton Duncan, Sarah Logan, Kent Anderson; The effect of pterygium surgery on corneal astigmatism. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3103. doi: https://doi.org/.
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Quantify the effect pterygium surgery has on corneal astigmatism and identify factors that may predispose patients to have lesser or greater astigmatism after pterygium surgery. Calculate the success rate of pterygium surgery by looking at recurrence rate and identify those factors predisposing to recurrence.
An IRB approved retrospective chart review of all Texas Diabetes Institute (TDI) patients that underwent pterygium surgery at the University Hospital System (UHS) and the Medical Arts and Research Center (MARC) over a 3 year period was completed. Sex, age, race, and pterygium details including eye (left vs right), side (nasal vs temporal), primary vs recurrent, and size were analyzed. Surgery details including duration, surgical technique, medications (pre-, intra-, post-), surgeon(s), and site were also included in analysis. Pre- and post-operative simulated topography and refraction were compared to determine statistical significance. Factors associated with changes in astigmatism and recurrence rates were analyzed.
Review and analysis was completed on records from 92 eyes from 82 patients. The total mean pre-operative (3.46, S.D. 0.62) and mean post-operative (1.99, S.D. 1.85) simulated corneal astigmatism values were significantly different (P <0.01). Despite significant simulated corneal astigmatic difference, there was a trend, but no statistical significant difference between mean pre-operative and post-operative subjective refractive cylinder values (P = 0.05). Total pterygium size and presence of both nasal and temporal pterygia were associated with both increase amount of pre-operative and mean change in astigmatism. The rate of pterygium recurrence after surgery was 15.3%. Previous recurrence and total pterygium size were associated with recurrence of pterygium.
In this reviewed group of patients that underwent pterygium surgery simulated corneal astigmatism was significantly reduced after pterygium surgery, but no significant difference in mean subjective cylinder was found. Factors that are associated with pterygium recurrence should be noted pre-operatively and surgical planning should be addressed and explained to patients.
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