Outcomes of sequential pterygium and cataract surgery: A prospective case series

Abstract

Aim: To evaluate the visual outcome and corneal stability after sequential pterygium and cataract surgery in patients presenting with both pterygium and cataract. Materials and Methods: Twenty patients with pterygium more than 2mm on the cornea with immature cataract underwent sequential pterygium surgery with conjunctival auto-graft secured by autologus blood followed by manual small incision cataract surgery after one month as the cornea stabilizes. Results: The mean age of the patients was 59.80±6.71 years. Nasal pterygium was present in 19 (95%), while one had both nasal and temporal pterygium in same eye. The immature cataract was nuclear sclerosis grade 2- 3 in all cases with posterior sub capsular cataract of variable densities. The mean uncorrected distant visual acuity UDVA at presentation was 0.95±0.27 logMAR units significantly improved post sequential pterygium and cataract surgery to 0.12±0.12 logMAR units (P < 0.001, Paired samples t-test). After sequential pterygium and cataract surgery the mean manifest astigmatism of the 17 (85%) patients with UDVA6/9 – 6/6 and the 3 (15%) patients with UDVA 6/12 were – 0.42 D and -1.33D respectively. Conclusion: The sequential surgery of pterygium excision with conjunctival autograft followed by manual small incision cataract surgery is the safe and effective way in providing the better visual outcome with proper counseling of patients regarding the outcome and their participation. Keywords: Conjunctival autograft, Manual small incision cataract surgery, Pterygium.