Background: Pterygium is a wing-shaped proliferative disease of the conjunctival and the subconjunctival tissues invading the cornea. Its prevalence is reported at 10.2% and occurs in patients ranging widely in age. To reduce the rate of recurrence following surgical treatment of pterygium, various techniques have been applied which include pterygium resection combined with conjunctival auto-graft. Refractive and topographic changes caused by pterygium are reversible after pterygium exision.
Objective: This study was conducted to study corneal topographic changes after pterygium surgery with conjunctival autograft versus pterygium surgery with intraoperative application of topical mitomycin C with bare sclera.
Patients and methods: This randomized controlled study included 30 eyes who were randomly divided into two groups each of 15 eyes; group 1 that included patients underwent pterygium excision with conjunctival autograft and group 2 that included patients underwent pterygium excision with Intraoperative Application of Topical Mitomycin C with bare sclera. The cases were recruited from Ophthalmology Department, Al-Azhar University hospitals, Cairo, Egypt.
Results: In the Conjunctival autograft group, there was non-statistically significant difference found between Preoperative and Postoperative regarding thinnest location thickness and there was statistically significant difference between Preoperative and Postoperative regarding K2 (Decrease), Average K (increase) Coma Aberration (Decrease) and Spherical Aberration and (Decrease) there was highly statistically significant difference regarding Astigmatism, BCVA (improvement) K1 (decrease) and High Order Aberration (decrease). In the mitomycin C group, there was there was non-statistically significant difference found between Preoperative and Postoperative regarding thinnest location thickness but there was statistically significant difference regarding K2 (Decrease) and Average K (increase). And there was highly statistically significant difference regarding BCVA (improvement), K1 (Increase) High Order Aberration (decrease), Coma Aberration (decrease), Spherical Aberration (decrease) and Astigmatism (decrease). All topographic changes caused by pterygium are improved after pterygium surgery either in CAG group or MMC group but astigmatism much improved in MMC group and HOA much improved in CAG group.
Conclusion: Pterygium excision can cause changes in the keratometric and cylindrical power of the anterior corneal surface and axis of astigmatism. The cornea becomes steeper. The changes occur in pterygium exsion with CAG and also with MMC. And so IOL calculation should be avoided in patient with pterygium either for cataract surgery, CLE or ICL implantation.