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Early Keratometric and Scheimpflug Topographic Stabilization after Pterygium Excision with Conjunctival Autograft: A
Farhat Siddiqui1, Raj Nath Singh Kushwaha2, Perwez Khan3
1Ophthalmology Department, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Objective:
To evaluate early corneal stabilization following pterygium excision with conjunctival autograft, using keratometry and Scheimpflug imaging, and to compare outcomes with recent evidence.
Methods:
In this prospective cohort of 70 eyes (February 2019-February 2020), primary nasal pterygium excision with conjunctival autograft was performed using either fibrin glue (n = 35) or Autologous plasma (n = 35). Keratometric and Scheimpflug parameters [corneal astigmatism, index of surface variance (ISV), index of vertical asymmetry (IVA), maximum keratometry (Kmax), posterior corneal astigmatism] were assessed preoperatively, and at 1- and 2-month follow-up. Outcomes were compared using paired t-tests and subgroup analysis.
Results:
Mean keratometric astigmatism decreased from 1.35 ± 1.12 D preoperatively to 0.71 ± 0.65 D at 2 months (p < 0.001). Scheimpflug-derived astigmatism reduced from 1.22 ± 0.95 D to 0.89 ± 0.71 D (p < 0.001). ISV improved from 42.6 ± 6.4 to 33.2 ± 4.9 (p < 0.01), IVA from 0.38 ± 0.12 to 0.29 ± 0.10 (p < 0.01), and Kmax decreased modestly (p < 0.05). Outcomes were comparable between glue and suture groups (p > 0.05). Recurrence occurred in 3 eyes (4.3%).
Discussion:
The present study demonstrated early stabilization of keratometric and Scheimpflug parameters following pterygium excision with conjunctival autograft, suggesting that significant corneal remodeling occurs within the early postoperative period.
Conclusions:
Pterygium excision with conjunctival autograft yields a significant early reduction in astigmatism and an improvement in corneal surface regularity by 2 months, independent of fixation technique. These results support early refractive rehabilitation and spectacle planning after surgery.