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Healing indicators after pterygium excision by optical coherence tomography
Pere Pujol1, Gemma Julio, Miriam Barbany
1Department of Ophthalmology, Hospital de Terrassa, Terrassa, Spain; Ocular Surface Research Group, Optics and Optometry Department, Universitat Politècnica de Catalunya-Barcelona Tech, Terrassa, Spain.
Optical coherence tomography (OCT) reveals that successful pterygium excision healing begins with corneal epithelium restoration and concludes with limbal area normalization. Identifying the limbal demarcation area via OCT is a strong indicator of positive surgical outcomes.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Medical Imaging
Background:
- Pterygium excision aims for complete tissue recovery.
- Understanding the timeline of tissue restoration post-surgery is crucial for assessing healing.
- Optical coherence tomography (OCT) offers high-resolution cross-sectional imaging of ocular tissues.
Purpose of the Study:
- To map the sequence of tomographic changes during tissue recovery after pterygium excision.
- To identify reliable indicators of successful healing using OCT.
- To differentiate between healing patterns and recurrence using OCT findings.
Main Methods:
- Prospective study involving 73 patients undergoing pterygium excision.
- Serial OCT imaging at 1 week, 1, 3, and 6 months post-surgery.
- Biomicroscopy for clinical assessment of healing and recurrence.
- Analysis of corneal epithelium, conjunctival epithelium, limbal demarcation, and graft thickening.
Main Results:
- Eyes without recurrence (NR group) showed progressive identification of normal anatomical structures by OCT compared to the recurrence group (R group).
- Differences in corneal epithelium visualization emerged as early as 1 month post-surgery.
- Identification of the limbal demarcation area was significantly higher in the NR group by 6 months and absent in the R group.
- Graft thickening, a pathological sign, decreased over time in both groups without significant difference.
Conclusions:
- Tissue restoration after pterygium excision follows a sequence from the cornea to the limbus, mirroring the injury process in reverse.
- Early visualization of corneal epithelium may indicate successful surgery.
- The presence of a normal limbal pattern, specifically the limbal demarcation area on OCT, is a robust positive predictor of surgical healing.
