Long-term changes and effect of pterygium size on corneal topographic irregularity after recurrent pterygium surgery

Takashi Ono,Yuji Nagata,Yosai Mori,Makoto Aihara,Kentaro Abe,Ryohei Nejima,Kazunori Miyata,Takuya Iwasaki,Jinhee Lee

doi:10.1038/s41598-020-65376-4

Takashi Ono, Yuji Nagata + Show 7 more

Open Access

https://doi.org/10.1038/s41598-020-65376-4

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Journal: Scientific Reports	Publication Date: May 21, 2020
Citations: 8	License type: open-access

Affiliation: Miyata Eye Hospital, The University of Tokyo

Abstract

This retrospective observational study compared long-term topographic changes after recurrent- and primary-pterygium surgery depending on pterygium size. Patients who underwent recurrent-pterygium excision between 2002–2013 and age, sex, and pterygium size-matched controls who underwent primary-pterygium surgery were included (33 eyes of 33 patients in each group). Pterygium size was graded per advancing edge position: <1/3 of corneal diameter (grade 1), outside the pupil (grade 2), and within the pupillary area (grade 3). Surface asymmetry index (SAI), surface regularity index (SRI) in corneal topography, and uncorrected and best-spectacle-corrected visual acuity were compared before and 1, 3, 6, and 12 months postoperatively. Three, 17, and 13 eyes had grades 1, 2, and 3, respectively. In grade 2, the SAI and SRI were respectively significantly larger at all observation points (p = 0.01, 0.03, 0.02, 0.02, and 0.004) and before and 6 and 12 months postoperatively (p = 0.02, 0.04, and 0.03) in recurrent pterygium. In grade 3, the SAI was significantly larger before and 1, 3, and 12 months postoperatively (p = 0.04, 0.01, 0.01, and 0.02) and the SRI was significantly larger before and 12 months postoperatively (p < 0.001, 0.02) in recurrent pterygium. Corneal irregularity persisted 12 months after recurrent-pterygium surgery compared with that in same-size primary pterygium.

Highlights

This retrospective observational study compared long-term topographic changes after recurrent- and primary-pterygium surgery depending on pterygium size
In grade 1, there was no significant difference in the Surface asymmetry index (SAI), surface regularity index (SRI), preoperative uncorrected visual acuity (UCVA), preoperative best spectacle-corrected visual acuity (BSCVA), corneal astigmatism, and corneal refractive power between the two groups
In grade 2, the SAI and SRI were larger in the recurrent-pterygium than in the primary-pterygium group (p = 0.01 and 0.02, respectively)

Summary

Introduction

This retrospective observational study compared long-term topographic changes after recurrent- and primary-pterygium surgery depending on pterygium size. Corneal irregularity is an important consideration in maintaining good visual acuity and visual function after pterygium surgery and it does not improve early postoperatively; restoration of the corneal surface requires a long time, and Nejima et al have reported that 6 to 12 months are needed to attain stability of corneal irregularity for larger sized pterygium[7]. They have demonstrated that the restoration of corneal topographic changes after surgery of the primary pterygium depended on pterygium size[7]. We compared the long-term topographic changes after surgery for recurrent and primary pterygium depending on pterygium size

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Results

Conclusion