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Year : 2021  |  Volume : 33  |  Issue : 3  |  Page : 316-321

Decision making in pterygium surgery: Our experience noting the length of pterygium

East Point Medical College and Research Centre, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Anjali Lita Roche
A-4, 502, AWHO, Sandeep Vihar, Kannamangala, Kadugodi, Bangalore – 560047
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_33_21

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Background: This is a prospective study which aims: To compare the preoperative and postoperative corneal astigmatism in patients undergoing pterygium excision by conjunctival autograft technique using autologous blood. To determine the correlation of pterygium length with preoperative and postoperative corneal astigmatism and thus ascertain an early indication for pterygium surgery. Materials and methods: 75 patients with primary pterygia were evaluated after dividing them into three groups based on length, Grade A - < 2mm, Grade B - 2 – 4mm and Grade C - > 4mm. Preoperative and postoperative corneal astigmatism were compared between the three groups using autorefraction and keratometer readings. Postoperative astigmatism was recorded on three visits – day 7, day 28 and third month. Statistical analysis: Statistical Package for Social Sciences (SPSS) version 19.0 for windows was used. Spearman's rank order (χ) was calculated to observe correlation of pterygium length with the preoperative and postoperative corneal astigmatism. A p-value < 0.05 was considered statistically significant. Results: The mean length of the pterygium was 2.77 ± 0.12mm. Majority had with – the – rule astigmatism (64%). Postoperatively mean uncorrected visual acuity (UCVA) increased significantly from 0.533 ± 0.03 to 0.78 ± 0.03 (P < 0.0001). Preoperative mean keratometric astigmatism of 2.55 ± 0.36D significantly decreased to 1.213 ± 0.20D postoperatively (r = 0.89, P < 0.0001). A positive correlation between the length of pterygium and both preoperative (χ = 0.68, P < 0.001) and postoperative (χ = 0.53, P < 0.001) corneal astigmatism was observed. Conclusion: The increase in the length of pterygium significantly correlated with the degree of preoperative corneal astigmatism. The evidence of significant improvement in visual acuity and decrease in pterygium induced corneal astigmatism was observed three months postoperatively by conjunctival autograft technique with autologous blood. Hence, pterygium induced corneal astigmatism of length > 2mm is an early indication for surgical intervention.

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