A study on changes in corneal refractive and corneal surface regularity before and after pterygium excision surgery
TAO Lihui1,2 YANG Weihua1▲
1.Department of Ophthalmology, the First Affiliated Hospital of Huzhou University, Zhejiang Province, Huzhou 313000, China;
2.Department of Nursing, the First Affiliated Hospital of Huzhou University, Zhejiang Province, Huzhou 313000, China
Abstract：Objective To assess the corneal refractive and corneal surface regularity changes before and after pterygium excision surgery. Methods A total of 126 clinical data of patients with pterygium who received surgery in the First Affiliated Hospital of Huzhou University from March 2016 to June 2017 were analyzed retrospectively and were divided into three groups according to the position of the advancing pterygium edge with respect to corneal diameter: less than one third of corneal diameter (group Ⅰ, 50 cases, 50 eyes), between one third of corneal diameter and the pupil (group Ⅱ, 46 cases, 46 eyes) and within the pupillary area (group Ⅲ, 30 cases, 30 eyes). Average corneal power (ACP), corneal astigmatism (CA), surface regularity index (SRI) and surface asymmetry index (SAI) were analyzed by topographic modeling system using one-way analysis of variance (ANOVA). Statistical analysis of ACP, CA, SRI and SAI were done by corneal topography before, 3 months and 6 months after pterygium excision surgery using one-way analysis of variance (ANOVA). Results With the increase in the grades of pterygium, CA, SRI and SAI were increased, ACP was decreased. ANOVA showed that there were highly statistically significant differences in CA, SRI, SAI and ACP among the three groups (all P ＜ 0.01). CA, SRI and SAI in group Ⅱ and group Ⅲ were all higher than those of group Ⅰ, group Ⅲ was higher than that of group Ⅱ, with statistically significant differences (all P ＜ 0.05). ACP in group Ⅲ were lower than those of group Ⅰ and group Ⅱ, with statistically significant differences (P ＜ 0.05), but there was no statistically significant difference between group Ⅰ and group Ⅱ(P ＞ 0.05). ANOVA showed that there were highly statistically significant differences in CA, SRI, SAI and ACP before operation, 3 month and 6 month after operation (all P ＜ 0.01). After operation of 3 month and 6 month, CA, SRI and SAI were significantly lower than those before operation, ACP was higher than that of before operation, with statistically significant differences (all P ＜ 0.01); there were no statistically significant differences in CA, SRI, SAI and ACP between 3 month and 6 month after operation ( all P ＞ 0.05). Conclusion The topographic indices of ACP, CA, SRI and SAI are associated with pterygium size. With increasing size of pterygium, CA, SRI and SAI were increased, ACP was decreased. The regularity of corneal surface can be improved and CA can be reduced after pterygium excision surgery.
陶丽惠1，2 杨卫华1▲. 翼状胬肉患者手术前后角膜屈光状态及角膜表面规则性的研究[J]. 中国医药导报, 2018, 15(15): 115-118.
TAO Lihui1,2 YANG Weihua1▲. A study on changes in corneal refractive and corneal surface regularity before and after pterygium excision surgery. 中国医药导报, 2018, 15(15): 115-118.
[1] Lin A，Stern G. Correlation between pterygium size and induced corneal astigmatism [J]. Cornea，1998，17（1）：28-30.
[2] Mohammadpour M，Amouzegar A，Hashemi H，et al. Comparison of Lotrafilcon B and Balafilcon A silicone hydrogel bandage contact lenses in reducing pain and discomfort after photorefractive keratectomy：A contralateral eye study [J]. Cont Lens Anterior Eye，2015，38（3）：211-214.
[3] Pavilack MA，Halpern BL. Corneal topographic changes induced by pterygia [J]. J Refract Surg，1995，10（3）：92-95.
[4] Kenyon KR，Wagoner MD，Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium [J]. Ophthalmology，1985，92（11）：1461-1470.
[5] 宋玉艳，谢铃，刘素芝，等.两种不同手术方式治疗翼状胬肉的比较[J].中华眼外伤职业眼病杂志，2017，4（12）：940-942.
[6] Tananuvat N，Martin T. The results of amniotic membrane transplantation for primary pterygium compared with conjunctival autograft [J]. Cornea，2004，23（5）：458-463.
[7] 韦启俪，周旭.翼状胬肉切除术联合羊膜移植及丝裂霉素C治疗翼状胬肉的临床效果观察[J].广西医学，2017， 39（5）：710-712.
[8] Kheirkhah A，Izadi A，Kiarudi MY，et al. Effects of mitomycin C on corneal endothelial cell counts in pterygium surgery：role of application location [J]. Am J Ophthalmol，2011，151（3）：488-493.
[9] Chui J，Di GN，Wakefield D，et al. The pathogenesis of pterygium：current concepts and their therapeutic implications [J]. Ocul Surf，2008，6（1）：24-43.
[10] 张明昌，王勇.重视翼状胬肉的基础与临床研究[J].中华眼科杂志，2007，43（10）：868-871.
[11] Park TK，Jin KH. Telomerase activity in pterygeal and normal conjunctival epithelium [J]. Korean J Ophthalmol，2000，14（2）：85-89.
[12] Tan DT，Tang WY，Liu YP，et al. Apoptosis and apoptosis related gene expression in normal conjunctiva and pterygium [J]. Br J Ophthalmol，2000，84（2）：212-216.
[13] Maheshwari S. Pterygium-induced corneal refractive cha?鄄nges [J]. Indian J Ophthalmol，2007，55（5）：383-386.
[14] 赵江浩.翼状胬肉切除术后角膜地形图及散光度的改变[J].中华眼视光学与视觉科学杂志，2009，11（5）：386-388.
[15] 李纳，邹留河，苏晓铎，等.翼状胬肉大小与角膜地形图的相关性研究[J].眼科，2003，12（6）：333-335.
[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 [J]. Eye Contact Lens，2015，41（1）：58-63.
[17] Rana AY，Cem K，Aylin K，et al. Astigmatic changes following pterygium removal：Comparison of 5 different methods [J]. Indian J Ophthalmol，2013，61（3）：104-108.
[18] 刘祖国，谢玉环，张梅，等.干眼病患者角膜表面规则性及人工泪液对角膜表面规则性的影响[J].中华眼科杂志，2000，36（2）：131-134.
[19] Shiotani Y，Maeda N，Inoue T，et al. Comparison of topographic indices that correlate with visual acuity in videokeratography [J]. Ophthalmology，2000，107（3）：559-564.
[20] 李庆祥，杜君.翼状胬肉切除联合自体角膜缘干细胞移植术前后角膜屈光状态的变化[J].眼科新进展，2009，（9）：705-706，712.
[21] 马子伟，童峰峰，刘云芳，等.翼状胬肉术后角膜屈光状态稳定时间的临床观察[J].国际眼科杂志，2013，13（11）：2360-2361.
2018, Vol. 15 
京公网安备 11010502046598号