Refractive Change following Pterygium Surgery

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We conducted a prospective study of patients with primary pterygia to analyze surgically-induced astigmatic changes following pterygium surgery and their relation to pterygium morphology and size.


One hundred twenty-three eyes of 123 adult patients with primary pterygia were evaluated. Pterygium was graded according to morphology and the extent of corneal encroachment. Manifest refraction was performed preoperatively and at 1,3, and 6 months postoperatively. Patients underwent either the bare sclera technique of pterygium excision or conjunctival grafting. Surgery was performed by one surgeon. Olsen's method of vector decomposition was used to analyze surgically-induced astigmatism.


The mean magnitude of preoperative astigmatism was 0.99 D, with vector decomposition revealing a relative flattening of the cornea in the horizontal meridian. Astigmatism of 1.00 D or more was seen when the pterygium exceeded 3.5 mm beyond the limbus. Postoperatively, a steepening of the cornea in the horizontal meridian was demonstrated, the magnitude of which was related to pterygium size (P=0.0001). ANOVA testing showed no significant difference (P> 0.05) when pterygia were divided according to morphology.


This study confirms that pterygium excision induces a reversal of pterygium-related corneal flattening. A strong correlation was also found between the horizontal extent of pterygium encroachment and astigmatic change following surgery.

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