To study the effect of pterygium excision on corneal curvature and contrast sensitivity
Abstract
Introduction: To evaluate the corneal astigmatism and contrast sensitivity before and after pterygium surgery and to study the relationship between amount of astigmatism and contrast sensitivity in various grades of pterygia.
Material and Method: Sixty three eyes of 63 patients with primary pterygia were studied before and after surgery. The astigmatism induced by primary pterygium was measured by manual keratometer and contrast sensitivity by Pelli Robson chart. Preoperative and postoperative values were compared using paired t –test and ANOVA test.
Result: Astigmatism decreased significantly following pterygium excision. The mean preoperative refractive cylinder decreased from 3.29±1.46 D to 1.49±0.82 D postoperatively. Surgical removal of pterygium caused a significant reduction in refractive astigmatism. The amount of astigmatism decreased significantly following pterygium excision in grade II , grade III and in grade IV. In grade I pterygium, decrease in the amount of astigmatism was not statistically significant (p=0.515). The contrast sensitivity increased significantly following pterygium excision. The mean preoperative contrast sensitivity increased from 1.49±0.21 to 1.70±0.20 postoperatively. Surgical removal of pterygium caused a significant improvement in contrast sensitivity.
Conclusions: Surgical excision of pterygium improves contrast sensitivity, visual acuity and reduces astigmatism. Contrast sensitivity testing may provide additional objective methods for documenting impaired vision in patients with pterygium when Snellen visual acuity is minimally affected. Corneal astigmatism and contrast sensitivity values in patients with pterygia are useful indicators for the need of pterygium surgery or as indicators of surgical success.
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2. Taylor HR, West SK, Rosenthal FS, Munoz B, Newland HS, Emmett EA. Corneal changes associated with chronic UV irradiation. Arch Ophthalmol. 1989 Oct;107(10):1481-4. [PubMed]
3. Threlfall TJ, English DR. Sun exposure and pterygium of the eye: a dose-response curve. Am J Ophthalmol. 1999 Sep;128(3):280-7. [PubMed]
4. David B. Elliott, Mark A. Bullimore and Ian L. Bailey. Improving the reliability of the pelli-robson contrast sensitivity test. Clin. Vision Sci. Vol. 6,No. 6,pp. 471-475,1999. [PubMed]
5. Tomidokoro A, Miyata K, Sakaguchi Y, Samejima T, Tokunaga T, Oshika T. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology. 2000 Aug;107(8):1568-71. [PubMed]
6. Gütay A, Küchle M, Kus MM, Langenbucher A Impact of pterygium size on corneal topography and visual acuity - a prospective clinical cross-sectional study. Lindsay RG1, Sullivan LKlin Monbl Augenheilkd. 2001 Sep;218(9):609-1.
7. Bahar, Irit MD; Loya, Nisim MD; Weinberger, Dov MD; Avisar, Rahamim MD.Effect of Pterygium Surgery on Corneal Topography:: A Prospective Study Cornea: 2004 Mar;23(2):113-7. [PubMed]
8. Yilmaz S, Yuksel T, Maden A. Corneal topographic changes after four types of pterygium surgery. J Refract Surg. 2008 Feb;24(2):160-5. [PubMed]
9. Oldenburg JB, Garbus J, McDonnell JM, McDonnell PJ. Conjunctival pterygia. Mechanism of corneal topographic changes. CorneaCan J Ophthalmol. 2012 Oct;47(5):423-8. doi: 10.1016/j.jcjo.2012.07.002. [PubMed]
10. Cinal A, Yasar T, Demirok A, Topuz H. The effect of pterygium surgery on corneal topography. Ophthalmic Surg Lasers. 2001 Jan-Feb;32(1):35-40. [PubMed]
11. Hong JW ,Lee TS. Comparison of Refractive Change Measured by corneal topography before and after pterygium excision.J Korean opthalmol Soc. 1996 Oct(10):1614-1689. [PubMed]
12. Yagmur M, Ozcan AA, Sari S, Ersöz TR. Visual acuity and corneal topographic changes related with pterygium surgery. J Refract Surg. 2005 Mar-Apr;21(2):166-70. [PubMed]
13. Yousuf M. Role of pterygium excision in pterygium induced astigmatism. JK-Practitioner 2005;12:91-2.
14. Maheshwari S. Effect of pterygium excision on pterygium induced astigmatism. Indian J Ophthalmol. 2003 Jun;51(2):187-8. [PubMed]
15. Stern GA, Lin A. Effect of pterygium excision on induced corneal topographic abnormalities. Cornea. 1998 Jan;17(1):23-7. [PubMed]
16. Applegate RA, Hilmantel G, Howland HC, Tu EY, Starck T, Zayac EJ. Corneal first surface optical aberrations and visual performance. J Refract Surg. 2000 Sep-Oct;16(5):507-14. [PubMed]
17. Pesudovs K, Figueiredo FC. Corneal first surface wavefront aberrations before and after pterygium surgery. J Refract Surg. 2006; 22: 921–5. [PubMed]
18. Gumus K, Topaktas D, Göktaş A, Karakucuk S, Oner A, Mirza GE. The change in ocular higher-order aberrations after pterygium excision with conjunctival autograft: a 1-yearprospective clinical trial. Cornea. 2012 Dec;31(12):1428-31. doi: 10.1097/ICO.0b013e3182431465.
19. Kwon SM, Lee DJ, Jeung WJ, Park WC. Power vector and aberrations using corneal topographer and wavefront aberrometer before and after pterygium surgery. J Korean Ophthalmol Soc. 2008; 49: 1737–45.
20. Applegate RA, Hilmantel G, Howland HC, Tu EY, Starck T, Zayac EJ. Corneal first surface optical aberrations and visual performance. J Refract Surg. 2000 Sep-Oct;16(5):507-14. [PubMed]
21. Lin S, Reiter K, Dreher AW, Frucht-Pery J, Feldman ST. The effect of pterygia on contrast sensitivity and glare disability. Am J Ophthalmol. 1989 Apr 15;107(4):407-10. [PubMed]
22. Oh JY, Wee WR. The effect of pterygium surgery on contrast sensitivity and corneal topographic changes. Clin Ophthalmol. 2010 Apr 26;4:315-9. [PubMed]
23. Razmjoo H, Vaezi MH, Peyman A, Koosha N, Mohammadi Z, Alavirad M. The effect of pterygium surgery on wave front analysis. Adv Biomed Res. 2014 Sep 23;3:196. doi: 10.4103/2277-9175.140677. eCollection 2014. [PubMed]
24. Pujol P, Julio G, de Carvalho AM, Kostov B, Martí-Huguet T. Threshold to predict astigmatism reduction after pterygium excision. Optom Vis Sci. 2014 Jul;91(7):747-51. doi: 10.1097/OPX.0000000000000307.