Volume : VIII, Issue : VIII, August - 2019

A STUTY OF REFRACTIVE CHANGES AFTER PRIMARY PTERYGIUM SURGERY

Dr. Parth R. Tandel, Dr. Manisha N. Patel, Dr. Khushnood M. Sheikh

Abstract :

INTRODUCTION: Pterygium is fiovsacular degeneration of the subconjuctival tissue encroaching cornea induces with the rule astigmatism which causes diminission of vision. After removal of pterygium, induced astigmatism is reveresed and improving in vision is noted. AIMS AND OBJECTIVE: To assess amount of astigmatism before and after pterygium surgery, to find correlation of postoperative refractive outcome with size of pterygium at time of surgery, and to assess duration of postoperative recovery time after pterygium surgery. METHOD: The present study is a hospital based prospective observational study of patients attending the outdoor patient department of Ophthalmology and those who were admitted in ophthalmic ward. All the patients in study were evaluated and operated during study period of 18 months from April 2017 to September 2018 which were 46 patients. The patient’s personal identification information was recorded with registration number. All patients were evaluated for best corrected visual acuity by illuminated Snellen’s chart for 6–meter distance, near vision was measured with Roman’s near vision chart. Slit lamp bio microscopy was performed with Haag–Streit BQ 900 and Nippon slit lamp. Pterygium encroaching cornea measured with horizontal slit of the slit lamp in mm and graded. Refraction and keratometry was done with autorefractokeratometer and Bausch and Lomb keretometer. Detailed fundus examination was done with direct ophthalmoscope and Slit lamp biomicroscopy with 90D lens (volk). Than after blood and urine examination necessary for pterygium surgery under local anaesthesia, patient admitted in ward posted for surgery. All the patients had same preoperative, operative and post–operative work up. The patients were operated using the same technique. Biomicroscopic, refractive and fundoscopic examinations, keratometry readings were performed on all patients postoperatively and at 1st month and 3rd month. All findings were recorded in detailed proforma. OBSERVATION: Study population consisted of individuals in mean age group of 52.5+16 years, in which 61–70 years had 32.60% followed by 31–40 years (23.91%). Females were 25(54.35%) out of 46 as compared to male were 21(45.65%), were more as compared to male for which cosmesis may be a driving factor. In present study, 19(41.30%) out of 46 patients had left eye involvement and 18(39.13%) out of 46 patients had right eye involvement. 9(19.57%) out of 46 patients had bilateral eye involvement. Most of patients had nasal side of pterygium which was in 45(97.83%) out of 46 and only 1 patient had temporal pterygium. BCVA improves from 0.787+0.23 pre–operatively to post–operative 0.86+0.16. The size was affecting the change in astigmatism as well as postoperative degree of astigmatism. Mean pterygium size was 3.73+0.88 mm. pterygium was graded according to corneal encroachment in which maximum were in grade 3–26(39.16%), grade 2–18(39.16%) and in grade 4–2(4.35%).Mean pre–operative pterygium induced astigmatism was 4.04+0.15 D which was reduced to 1.69+0.94 D post–operative at the end of 3 months. 2.1–3.00 mm induced 1.92+0.62 D which was reduced to 0.62+0.34 D, 3.1–4.00 mm induced 3.66+1.03 D which was reduced to 1.51+0.60 D, 4.1–5.00 mm induced 4.98+0.59 D which was reduced to 2.15+0.74 D and 5.1–6.0 mm induced 7.5+1.76 D which was reduced to 3.62+0.53 D at the end of 3 months. The refractive components were demonstrated to stabilize at 1 month following pterygium surgery. However, in present study, we included the postoperative 3rd months’ results to make sure that refraction was stabilized. The conventional keratometry evaluates the corneal refractive power from 3 or 4 data points. CONCLUSION: Pterygium induces with–the– rule astigmatism which reverses after primary excision.

Keywords :

Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

A STUTY OF REFRACTIVE CHANGES AFTER PRIMARY PTERYGIUM SURGERY, Dr. Parth R. Tandel, Dr. Manisha N. Patel, Dr. Khushnood M. Sheikh INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-8 | August-2019

Number of Downloads : 129

References :