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Threshold to predict astigmatism reduction after pterygium excision.

Pere Pujol1, Gemma Julio, Amelia M de Carvalho

  • 1*MsOphth †PhD ‡MD §MSc Department of Ophthalmology, Terrassa Hospital, Terrassa Health Consortium, Terrassa, Spain (PP, GJ, AMdC); Ocular Surface Research Group, Optics and Optometry Department, Universitat Politècnica de Catalunya, Terrassa, Spain (PP, GJ, TM-H); Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, Spain (BK); Department of Statistics and Operational Research, Universitat Politècnica de Catalunya, Barcelona, Spain (BK); and Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain (TM-H).

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|June 6, 2014
PubMed
Summary

Pterygium excision using limbal-conjunctival autograft (LCA) with or without mitomycin C (MMC) yields similar astigmatism reduction. Patients with over 1.05 diopters of preoperative astigmatism may see improvement after surgery.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Astigmatism Management

Background:

  • Pterygium excision is a common ophthalmic procedure.
  • Corneal astigmatism is a frequent complication or precursor to pterygium.
  • Limbal-conjunctival autograft (LCA) is a standard surgical technique for pterygium excision.

Purpose of the Study:

  • To compare corneal astigmatism outcomes after pterygium excision using LCA with and without mitomycin C (MMC).
  • To determine a predictive threshold for postoperative astigmatism reduction following pterygium surgery.

Main Methods:

  • Sixty-eight eyes with primary pterygium underwent LCA with (MMC+) or without (MMC-) MMC.
  • Corneal lesion characteristics and preoperative corneal astigmatism (PRCA) were assessed.
  • Postoperative corneal astigmatism (POCA) was measured at 1, 3, and 6 months.

Main Results:

  • Both LCA with and without MMC groups demonstrated significant astigmatism reduction at 1 month, which remained stable.
  • No significant differences in astigmatism reduction were observed between the MMC+ and MMC- groups.
  • A significant correlation was found between PRCA and POCA at 6 months (r = 0.529, p < 0.01).
  • A PRCA threshold of 1.05 diopters predicted astigmatism reduction with 82.5% sensitivity and 80.5% specificity.

Conclusions:

  • LCA with and without MMC provide comparable astigmatism reduction after pterygium excision.
  • Pterygium patients with PRCA exceeding 1.05 diopters are more likely to experience astigmatism reduction post-surgery.
  • The direct relationship between PRCA and POCA indicates partial astigmatism correction, emphasizing the importance of preoperative values relative to the threshold for optimal outcomes.