Effect of Pterygium Removal Combined with Conjunctival Autograft on Corneal Parameters in Swept-Source Imaging

Abstract

Background: Both pterygium ingrowth and excision determine alterations in corneal topography. The aim of this study was to evaluate the influence of pterygium removal combined with conjunctival autografts in addition to the use of human fibrin tissue glue on changes in corneal parameters as measured by 3-D swept-source anterior segment optical coherence tomography (AS-OCT) imaging. Methods: Sixteen eyes (16 patients) with pterygium that qualified for surgical treatment were enrolled in this study. Eye examination, slit lamp, and 3-D AS-OCT (CASIA 2) assessment were performed before the surgery and 7 days, 1 month, and 6 months after pterygium excision. Topographic parameters of both anterior and posterior surfaces of the cornea were analysed at each follow-up visit. Results: The gradual decrease in total astigmatism power from preoperative median 2.75 (6.15) D to 1.2 (1.1) D at 6-month follow-up (p = 0.034) was noted from the day 7 visit. Values were strongly influenced by variations of anterior cornea astigmatism. In contrast, a gradual total HOA reduction at the 1-month (from median 0.79 (1.3) D to 0.44 (0.27) D; p = 0.038) and at 6-month visits (0.25 (0.09); p = 0.001) was observed. Similarly, values were strongly influenced by variations of the anterior. Additionally, total average keratometry values increased from preoperative 44.05 (2.25) D to 44.6 (1.9) (p = 0.043) 1 month after the surgery. Conclusions: Significant steepening of the anterior cornea and a reduction in both astigmatism and HOA were observed after pterygium excision. The anterior corneal surface was an essential component of the total postoperative corneal topography values. Three-dimensional swept-source AS-OCT imaging seems to be a valuable tool for monitoring both the progression of the disease and postoperative effects in pterygium eyes.