Abstract
Objective: To compare change in refractive astigmatism and visual acuity following pterygium excision followed by sutureless and gluefree conjunctival autograft.Method: A prospective , non randomized , comparative and interventional case series .This study was carried out on 52 eyes of 50 patients with primary pterygium in one or both eyes .our surgical technique comprised of pterygium excision followed by sutureless and gluefree conjunctival autograft which had additional benefit of having lowest recurrence rate at present. Visual acuity and refractive astigmatism were assessed pre-operatively and post – operatively on 2nd month follow up.Result: The mean age of the patient was 40.9 ±12.09 years .17 patients (32.69%) had grade III pterygium,12 patients each (23.07%) were of grade I and grade II and 21.15% were of grade IV. There was significant reduction in refractive astigmatism (mean±s.d) and improvement in visual acuity (mean±s.d) in all grades of pterygium post – operatively along with recurrence of merely in 1 patient i.e. 1.92 %.Conclusion: The present study concludes that pterygium excision reduces refractive astigmatism, improves visual acuity with additional benefit of lowest recurrence rate credited to sutureless and gluefree conjunctival autograft.
Highlights
Triangular, wing shaped, fibro vascular connective tissue of bulbar conjunctiva towards and onto the cornea [1], leading to significant astigmatism [2,3]. pterygium is attributed to dry,dusty and hot climate .recent studies suggests that damage to limbal stem cells and activation of matrix metalloproteinase [4] due to u v rays triggers pterygium occurrence
Pterygium excision followed by sutureless and gluefree conjunctival autograft can be considered as a better technique to reduce astigmatism, improvement in visual acuity with additional benefit of low recurrence rate [14], in comparison to other techniques [15,16,17,18]
Table-4 shows the stage of pterygium. 63.46% pterygia were thick and progressive type while thin and stationary pterygia were encountered in 36.53% cases
Summary
Triangular, wing shaped, fibro vascular connective tissue of bulbar conjunctiva towards and onto the cornea [1], leading to significant astigmatism [2,3]. pterygium is attributed to dry ,dusty and hot climate .recent studies suggests that damage to limbal stem cells and activation of matrix metalloproteinase [4] due to u v rays triggers pterygium occurrence. The pterygium invades the superficial peripheral cornea along with destruction of bowman’s layer and the superficial corneal lamellae. As it moves towards the pupillary area it causes corneal distortion and visual loss. The progression of a pterygium onto the cornea leads to significant corneal distortion which eventually causes development of astigmatism. Pterygium leads to a considerable effect on corneal refractive status, measured by refraction, keratometry and corneal topography [2,10,11,12]. Such effects increase with the increase in the grade of pterygia. Pterygium excision followed by sutureless and gluefree conjunctival autograft can be considered as a better technique to reduce astigmatism, improvement in visual acuity with additional benefit of low recurrence rate [14], in comparison to other techniques [15,16,17,18]
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