DefinePK

Research Objective

To evaluate the impact of pterygium excision with conjunctival autografting on corneal astigmatism and visual acuity by comparing preoperative and postoperative outcomes.

Methodology

A quasi-experimental study conducted at the Clinical Ophthalmology Unit, Hayatabad Medical Complex, Peshawar, between May 2023 and April 2024. Sixty-eight patients with primary pterygium underwent surgical excision under topical anesthesia, followed by conjunctival autografting. Corneal astigmatism was measured preoperatively and one month postoperatively using automated keratometry. Data included demographic details, pre- and postoperative best-corrected visual acuity (BCVA), and postoperative complications. Statistical analysis was performed using SPSS 23.0 with a significance level of p < 0.05.

Methodology Flowchart

                        graph TD
    A["Enroll 68 Patients with Primary Pterygium"] --> B["Measure Preoperative Corneal Astigmatism and BCVA"];
    B --> C["Perform Surgical Excision with Conjunctival Autografting"];
    C --> D["Administer Postoperative Care and Medications"];
    D --> E["Measure Postoperative Corneal Astigmatism and BCVA at 1 Month"];
    E --> F["Assess for Postoperative Complications and Recurrence"];
    F --> G["Analyze Data using SPSS 23.0"];
    G --> H["Compare Preoperative and Postoperative Outcomes"];
    H --> I["Draw Conclusions"];                    

Discussion

Pterygium excision with conjunctival autografting effectively reduces corneal astigmatism by alleviating tractional forces on the cornea and restoring its regular curvature. This leads to significant improvements in visual acuity. The conjunctival autograft technique appears to be instrumental in minimizing recurrence risk. The study's findings are consistent with previous research, reinforcing the efficacy and safety of this surgical approach. Limitations include a short follow-up period and reliance on automated keratometry.

Key Findings

The mean preoperative corneal astigmatism of 2.71 ± 1.02 diopters (D) significantly reduced to 1.25 ± 0.73 D postoperatively (p < 0.001). Postoperative improvement in BCVA was observed in 88.2% of patients, with 64.7% improving by one line and 23.5% by two lines or more. Minimal complications were reported, including mild conjunctival inflammation in three cases, and no recurrences were documented during the one-month follow-up.

Conclusion

Pterygium excision with conjunctival autografting is an effective and safe surgical intervention for reducing corneal astigmatism and improving visual outcomes. The procedure restores corneal regularity, significantly enhances best-corrected visual acuity, and is associated with minimal postoperative complications and no recurrence within the follow-up period.

Fact Check

1. Mean preoperative corneal astigmatism: 2.71 ± 1.02 diopters. This was measured preoperatively.
2. Mean postoperative corneal astigmatism: 1.25 ± 0.73 diopters. This was measured one month postoperatively.
3. Percentage of patients with improved BCVA: 88.2%. This indicates a positive impact on functional vision.

Mind Map