Effect of pterygium surgery by using conjunctival auto graft and amniotic membrane graft on astigmatism and visual acuity
Journal Title: MedPulse -International Medical Journal - Year 2014, Vol 1, Issue 9
Abstract
Introduction: Pterygium is known to cause astigmatism which can have significant effect impact on vision astigmatism increases with increasing grades of pterygium and astigmatism decreases postoperatively after pterygium excision. Astigmatism seen in patients with pterygium represents both naturally occurring astigmatism and induced astigmatism. Aims and Objective: To study effect of pterygium surgery by using Conjunctival auto graft and Amniotic membrane graft on astigmatism and visual acuity. Material and Method: fifty cases of primary pterygium were enrolled in the study and were divided in two groups of 25 patients each. After receiving institutional ethical committee approval and informed consent from patients the study was conducted. Group A patients underwent pterygium excision with conjunctival auto-grafting whereas Group B patients underwent pterygium excision with amniotic membrane grafting. All the patients were followed up postoperatively on 2nd, 7th, 15th, 30th and 6 months. In all the patients, pre operative astigmatism and uncorrected and best corrected visual acuity was measured and compared. Automated keratometry in vertical and horizontal directions was used as method to estimate astigmatism. Calibration scale used was 0.25, as a routine protocol of hospital. Results: Mean age of patients in group A was 43.16±12.60 years whereas in group B mean age was 42.48±12.20 years. Mean pre-operative astigmatism of group A and group B patients was 3.21±2.84D and 2.77±1.96D respectively. Astigmatism was reduced to 1.22±1.26D in group A and 1.06±0.73D in group B on day-30. The reduction in astigmatism after surgical procedure on post operative day 30 was statistically significant in both the groups. The mean preoperative UCVA in group A and group B was 0.387±0.208 and 0.444±0.204 respectively. The mean post-operative UCVA on day 30 in group A and group B was 0.561±0.213 and 0.631±0.254 respectively. The post-operative improvement in UCVA on post operative day 30 was statistically significant in both the groups. The mean pre-operative best corrected visual acuity in group A and group B was 0.707±0.261 and 0.820±0.240 respectively. The mean UCVA improved to 0.681±0.179 postoperatively from 0.518±0.158 preoperatively and the mean BCVA improved to 0.950±0.120 postoperatively from 0.874±0.203 preoperatively. The changes in astigmatism, UCVA and BCVA were statistically significant. Conclusion: Early intervention in the form of pterygium excision with conjunctival autografting / amniotic membrane grafting, not only gives cosmetic results but effectively prevents progression of pterygium induced Astigmatism and avoids development of visual impairment also. Choice of graft; amniotic membrane graft or conjunctival autograft does not affect results in terms of Astigmatism and visual outcome.
Authors and Affiliations
Dhuwadhapare Pravinkumar Gangadhar, Khaire Bhaskar Shankar, Choudhary Kashinath G
Keywords
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