Changes in keratometry and refractive status pre and post pterygium surgery

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Original Article

Author Details : Bansari Vadodaria, Aishwariya Thakre, Rupali Maheshgauri*, Divya Motwani, Ashish Mishra

Volume : 5, Issue : 4, Year : 2019

Article Page : 205-216

https://doi.org/10.18231/j.ijooo.2019.049

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Abstract

Purpose: To study pterygium induced astigmatism. In this study, we have analyzed our results of refractive
status of pterygium patient after pterygium excision surgery. Up till now we have seen pterygium induced
astigmatism but with the help of this study we would like to find out refractive status of patient post
operatively which will help in refractive cataract surgery of patient having both pterygium and cataract.
Materials and Methods: Descriptive study was undertaken of 50 cases of patients diagnosed to have
pterygium induced astigmatism. Patients were explained about the study after which written and informed
consent was taken about their participation in the study. Demographic factors like age, sex, occupation
and address were recorded. Complete ophthalmic and medical history was taken, Visual acuity using
Snellen’s chart, Refractive status was deduced. Keratometery observed for horizontal and vertical diameters
corneal diopter by bausch and lomb keratometry. Pterygium induced astigmatism which were operated by
pterygium excision and conjuctival autograf t with suture or without suture. Patients were examined on
post operative day 1,7,21 for refractive status where the refractive status of patients with pterygium preoper
ative and post operative with conjunctival autograft with suture and without suture was evaluated.
Data was entered in Microsoft Excel and statistical analysis was done using software EpiInfo or SPSS.
Quantitative data was analysed in terms of Means and Standard Deviation. Qualitative data was analysed
with appropriate test of significance like Unpaired T test and Paired T test. The probability level of 0.05
was considered as statistically significant.
Result: There was significant difference was seen in mean KV and KH pre-operatively, on post operative
day 1 after pterygium excision surgery with conjunctival autograft with or without suture and on regular
follow up (p = 0.000), such that KV decreases while KH increases following surgery and serial follow up.
Mean (KV minus KH) pre-operatively, on post operative day 1 and on regular follow up was statistically
significant (p = 0.000). (KV minus KH) decreases after pterygium excision surgery with conjunctival
autograft with or without suture. Spherical and Astigmatic error reduces significantly after pterygium
excision surgery with conjunctival autograft with or without suture(p = 0.000).
Conclusion: Pterygium leads to significant high corneal astigmatism, which hampers vision of the patient.
Pterygium causes horizontal meridian flattening (KH).We concluded that, pterygium causes simple myopic
with the rule type of astigmatism and compound hypermetropic and myopic astigmatism type of refractive
error. With the rule astigmatism was most common pre-operatively. There is drastic changes in keratometry
readings pre-operatively and post surgical excision of pterygium tissue. Overall, after pterygium excision
surgery most of the patients had no refractive error except simple myopic type of refractive error. After
pterygium excision surgery astigmatism was reduced, in compound astigmatic type of refractive error.
There is definite change in refractive status in pterygiyum post pterygium surgery so with this study I would
like to deduce that, to get emmetropic status for cataract surgery or refractive cataract surgery pterygium
tissue excision should be done.

Keywords: Keratometry, Changes in keratometry readings in pterygium, Pterygium induced refractive error, Pterygium induced corneal, Astigmatism, Sutureless pterygium surgery, Post pterygium refractive error.

How to cite : Vadodaria B, Thakre A, Maheshgauri R, Motwani D, Mishra A, Changes in keratometry and refractive status pre and post pterygium surgery. IP Int J Ocul Oncol Oculoplasty 2019;5(4):205-216

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