Correlation between size of pterygium and corneal astigmatism of patients receiving operation at Sichon Hospital, Nakhon Si Thammarat
Keywords:
corneal, astigmatism, pterygiumAbstract
Background: A pterygium is caused by the degeneration of the conjunctiva with more veins to grow and spread into the cornea. It covers the white part of eyes over the cornea due to astigmatism which can result in people vision and daily life.
Objectives: To study correlative between size of pterygium and corneal astigmatism of patients and measure the size of pterygium that affects change of astigmatism significantly after surgery.
Method: Observational Analytic Studies seek to address the research question. Participants were recruited from patient receiving treatment at Sichon hospital between January and December 2019. Patients were received pterygium and astigmatism measurement before surgery and after surgery at 1 month and 3 months. Data were analyzed using Spearman rank correlation coefficient, Pair t-test and Receiver Operating Characteristic (ROC)
Results: In this study, 56 patients participated, 11 male (19.6%) and 45 female (80.4%) had pterygium, measured from the horizontal axis from the limbus, an average size of 3.48 millimeters, the average pterygium area was 11.04 square millimeters and it caused an astigmatism average 4.64 diopter. In addition, the pterygium area was positively correlated with astigmatism before and after surgery at a high level (0.80) with statistical significance (p-value<0.001) respectively. The compare levels of astigmatism before and after surgery at 1 month and 3 months was statistically significant decrease (p-value<0.001). Extension of pterygium exceeded 5.40 mm2 (89.47% of sensitivity, 55.56% of specificity) and 2.70 mm (79.0% of sensitivity, 55.6% of specificity) correlated a chance of reduction of astigmatism (2.01 diopter)
Conclusions: The area of pterygium is positively correlated with astigmatism. In particular, pterygium surgery will effectively reduce the astigmatism of the cornea. Area of pterygium greater than 5.4 mm2 and 2.7 mm in horizontal size will affect the maximum reduction of astigmatism. This may be useful in patient selection for pterygium excision.
References
Young AL, Cao D, Chu WK, Ng TK, Yip YW, Jhanji V, et al. The evolving story of pterygium. Cornea. 2018;37:S55-S7.
Lin Y-H, Sun C-C, Yeung L, Yu Y-W, Sun M-H, Chen K-J. Epidemiologic study of pterygium in Taiwan. Japanese journal of ophthalmology. 2019;63(4):297-303.
Van Acker SI, Haagdorens M, Roelant E, Rozema J, Possemiers T, Van Gerwen V, et al. Pterygium Pathology: A Prospective Case-Control Study on Tear Film Cytokine Levels. Mediators of inflammation. 2019;2019.
Heindl LM, Cursiefen C. Pterygium. Etiology clinical aspect and novel adjuvant therapies. Ophthalmology. 2010; 107(6): 517-20.
Malozhen SA, Trufanov SV, Krakhmaleva DA. Pterygium: Etiology, pathogenesis, treatment. Vestnik oftalmologii. 2017;133(5):76.
Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database of Systematic Reviews. 2016(2).
Levinger E, Sorkin N, Sella S, Trivizki O, Lapira M, Keren S. Posterior Corneal Surface Changes After Pterygium Excision Surgery. Cornea. 2020;39(7):823-6.
Bradley JC, Yang W, Bradley RH, Reid TW, Schwab IR. The science of pterygia. British journal of ophthalmology. 2010;94(7):815-20.
Gazzard G, Saw S, Farook M, Koh D, Widjaja D, Chia S, et al. Pterygium in Indonesia: prevalence, severity and risk factors. British Journal of Ophthalmology. 2002;86(12):1341-6.
Khan FA, Khan Niazi S, Khan DA. The impact of pterygium excision on corneal astigmatism. J Coll Physicians Surg Pak. 2014;24(6):404-7.
Altan-Yaycioglu R, Kucukerdonmez C, Karalezli A, Corak F, Akova YA. Astigmatic changes following pterygium removal: comparison of 5 different methods. Indian journal of ophthalmology. 2013;61(3):104.
Cajucom-Uy H, Tong L, Wong T-Y, Tay W-T, Saw S-M. The prevalence of and risk factors for pterygium in an urban Malay population: the Singapore Malay Eye Study (SiMES). British journal of ophthalmology. 2010;94(8):977-81.
Cardenas-Cantu E, Zavala J, Valenzuela J, Valdez-Garcia JE, editors. Molecular basis of pterygium development. Seminars in ophthalmology; 2016: Taylor & Francis.
Fonseca EC, Rocha EM, Arruda GV. Comparison among adjuvant treatments for primary pterygium: a network meta-analysis. British journal of ophthalmology. 2018;102(6):748-56.
Raiskup F, Solomon A, Landau D, Ilsar M, Frucht-Pery J. Mitomycin C for pterygium: long term evaluation. British journal of ophthalmology. 2004;88(11):1425-8.
Lubbad A, Giarmoukakis A, Skatharoudi C, Astyrakakis A, Siganos C. Long term results of pterygium excision using different surgical techniques: A retrospective study. J Clin Exp Ophthalmol. 2016;8:629.
Garg P, Sahai A, Shamshad MA, Tyagi L, Singhal Y, Gupta S. A comparative study of preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Indian journal of ophthalmology. 2019;67(7):1036.
Lawan A, Hassan S, Ifeanyichukwu EP, Yahaya HB, Sani RY, Habib SG, et al. The astigmatic effect of pterygium in a Tertiary Hospital in Kano, Nigeria. Annals of African medicine. 2018;17(1):7.
Fernandes AG, Salomão SR, Ferraz NN, Mitsuhiro MH, Furtado JM, Muñoz S, et al. Pterygium in adults from the Brazilian Amazon Region: prevalence, visual status and refractive errors. British Journal of Ophthalmology. 2020;104(6):757-63.
Kampitak K. The effect of pterygium on corneal astigmatism. Journal of the Medical Association of Thailand=Chotmaihet thangphaet. 2003;86(1):16.
ณวพล กาญจนรัณย์, วชิรา สนธิไชย. ความสัมพันธ์ระหว่างขนาดต้อเนื้อกับค่าสายตาเอียงที่กระจกตา. วารสารจักษุธรรมศาสตร์. 2558;10(1):57-63.
