Volume 4, Issue 4, December 2019, Page: 106-110
Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft
Shreesha Kumar Kodavoor, Cornea Services, the Eye foundation, Coimbatore, India
Soundarya B, Cornea Services, the Eye foundation, Coimbatore, India
Ramamurthy Dandapani, Cataract and Refractive Services, the Eye Foundation, Coimbatore, India
Received: Nov. 19, 2019;       Accepted: Dec. 16, 2019;       Published: Dec. 24, 2019
DOI: 10.11648/j.ijovs.20190404.19      View  170      Downloads  61
Abstract
Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.
Keywords
Phacoemulsification, Pterygium, Conjunctival Autograft
To cite this article
Shreesha Kumar Kodavoor, Soundarya B, Ramamurthy Dandapani, Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft, International Journal of Ophthalmology & Visual Science. Vol. 4, No. 4, 2019, pp. 106-110. doi: 10.11648/j.ijovs.20190404.19
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
J. C. S. Yam and A. K. H. Kwok et al, “Ultraviolet light and ocular diseases,” International ophthalmology, vol. 34, no. 2, pp. 383–400, 2013.
[2]
Kwok LS, Coroneo MT et al. A model for pterygium formation. Cornea 1994; 13: 219-24.
[3]
Cameron ME et al: Pterygium throughout the world. Springfield, Charles C Thomas, 1965, pp 141-171.
[4]
Hiller R, Giacometti L, Yuen K et al (1977) Sunlight and cataract: an epidemiologic investigation. Am J Epidemiol 105 (5): 450–459.
[5]
Hollows F, Moran D et al (1981) Cataract—The ultraviolet risk factor. Lancet 2 (8258): 1249–1250.
[6]
Huchbaum DR, Moskowitz SE, Wirtschafter JD et al: A quantitative analysis of astigmatism induced by pterygium. J Biomech 10: 735746, 1977.
[7]
Lim R, Mitchell P, Cumming RG et al. Cataract associations with pinguecula and pterygium: the Blue Mountains Eye Study. Am J Ophthalmol. 1998; 126: 717–719.
[8]
Ibechukwu BI et al. Simultaneous pterygium and intraocular surgery. Br J Ophthalmol. 1990; 74: 265–266.
[9]
Gulani A, Dastur YK et al. Simultaneous pterygium and cataract surgery. J Postgrad Med. 1995; 41: 8–11.
[10]
Kodavoor SK, Ramamurthy D, Tiwari NN, Ramamurthy S et al. Double-head pterygium excision with modified vertically split-conjunctival autograft: Six-year long-term retrospective analysis. Indian J Ophthalmol 2017; 65: 700-4.
[11]
Kamiya, Kazutaka MD, PhD; Shimizu, Kimiya MD, PhD et al. Predictability of Intraocular Lens Power Calculation After Simultaneous Pterygium Excision and Cataract Surgery. Medicine, December 2015 - Volume 94 - Issue 52 - p e2232.
[12]
Cinal A, Yasar T, Demirok A, et al. The effect of pterygium surgery on corneal topography. Ophthalmic Surg Lasers. 2001; 32: 35–40.
[13]
Yasar T, Ozdemir M, Cinal A, et al. Effects of fibrovascular traction and pooling of tears on corneal topographic changes induced by pterygium. Eye (Lond). 2003; 17: 492–496.
[14]
Errais K, Bouden J, Mili-Boussen I, et al. Effect of pterygium surgery on corneal topography. Eur J Ophthalmol. 2008; 18: 177–181.
[15]
Wu PL, Kuo CN, Hsu HL, et al. Effect of pterygium surgery on refractive spherocylinder power and corneal topography. Ophthalmic Surg Lasers Imaging. 2009; 40: 32–37.
[16]
Nejima R, Masuda A, Minami K, et al. Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic restoration. Eye Contact Lens. 2015; 41: 58–63.
[17]
Kim SW, Park S, Im CY, et al. Prediction of mean corneal power change after pterygium excision. Cornea. 2014; 33: 148–153.
[18]
Tomidokoro A, Miyata K, Sakaguchi Y, et al. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology. 2000; 107: 1568–1571.
[19]
Koc M, Uzel MM et al, Pterygium size and effect on intraocular lens power calculation. J Cataract Refract Surg. 2016 Nov; 42 (11): 1620-1625.
[20]
Gumus, Koray & I. Tung, Cynthia & Al-Mohtaseb, Zaina et al (2017). Management of Pterygium with Coexisting Cataract. 10.5005/jp/books/13069_21.
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