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Published on: July 10, 2018
Corneal Polishing After Pterygium Excision With Motorized Diamond Burr: A Randomized Control Trial
Pinto Chikkanayakanahalli Narasimhaiah1, Shikha Gupta, Sudarshan Khokhar
1Cornea and Refractive Services (C.N.P., S.G., S.K., M.V., T.D., T.A.), Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and Department of Biostatistics (R.M.P.), All India Institute of Medical Sciences, New Delhi, India.
Purpose:
To evaluate outcomes of motorized diamond burr polishing versus manual polishing after pterygium excision.
Setting:
Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi.
Design:
A randomized, interventional observer-masked controlled trial.
Methods:
Forty consecutive eyes underwent pterygium excision with fibrin, glue-assisted conjunctival autograft. In group 1 (20 eyes), polishing of the corneal bed was done using a crescent blade, and in group 2 (20 eyes), using a motorized diamond burr.
Results:
There was no difference in the 2 groups with respect to mean age (P=0.08), gender (P=0.3), preoperative uncorrected visual acuity (UCVA) (P=0.45), best spectacle-corrected visual acuity (BCVA) (P=0.52), spherical equivalent (P=0.5), mean astigmatism (P=0.7), tear function tests like tear break-up time, tear film meniscus height, Schirmer I and II (P=0.6, 0.5, 0.7, 0.9 respectively), pterygium dimension (P=0.4), and conjunctival autograft size (P=0.24). Mean intraoperative surgical time was significantly more in group 1 (16.9 ± 2.85 min) as compared with 12.25 ± 1.88 min in group 2 (P=0.0001). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, Schirmer I and II, and tear meniscus height at 6 months between 2 groups; however, significantly better UCVA was found in group 2 at 3 months (P=0.04). Surgically induced astigmatism (SIA) was significantly more in group 2 as compared with group 1 at 6 months (P=0.0006).
Conclusions:
Motorized diamond burr polishing of the corneoscleral bed during primary pterygium excision in comparison with manual polishing requires significantly lesser surgical time with better UCVA, decreased astigmatism, and greater SIA at 6 months, which indicates greater astigmatic correction.
