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原发性翼状胬肉切除术后的地形学变化及胬肉大小对地形学恢复的影响。

Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic restoration.

作者信息

Nejima Ryohei, Masuda Ayami, Minami Keiichiro, Mori Yosai, Hasegawa Yumi, Miyata Kazunori

机构信息

Miyata Eye Hospital, Miyazaki, Japan.

出版信息

Eye Contact Lens. 2015 Jan;41(1):58-63. doi: 10.1097/ICL.0000000000000065.

Abstract

OBJECTIVE

To assess the effect of pterygium size on time-course change of corneal topography after excision surgery of primary pterygium.

METHODS

Retrospective case series included eyes that underwent excisions of primary pterygium. Pterygium size was graded according to the advancing edge position: less than one third of corneal diameter (grade 1), outside the pupil (grade 2), and within the pupillary area (grade 3). Time-course changes in corneal refractive power, astigmatism, and irregularity (surface regularity and asymmetry indices) in corneal topographies over 12 months postoperatively were compared between the pterygium size grades.

RESULTS

Pterygium excision was performed on 562 eyes, consisting of 119, 338, and 105 eyes with grades 1 to 3, respectively. Grade 1 did not change in corneal irregularity, and there was no difference between grades 1 and 2, except for corneal astigmatism at 6 months. Grade 3 showed significantly higher corneal refractive power and irregularity than grade 1 until 3 and 6 months, respectively, whereas corneal astigmatism was higher over 12 months.

CONCLUSIONS

Topographic changes after primary pterygium excision were associated with pterygium size. Pterygium advancing over the pupillary area required 6 to 12 months for corneal topography restoration, resulting in slow recovery of visual acuity.

摘要

目的

评估原发性翼状胬肉切除术后胬肉大小对角膜地形图时间进程变化的影响。

方法

回顾性病例系列研究纳入了接受原发性翼状胬肉切除术的眼睛。根据胬肉前缘位置对胬肉大小进行分级:小于角膜直径的三分之一(1级)、在瞳孔之外(2级)和在瞳孔区域内(3级)。比较术后12个月内不同胬肉大小分级的角膜地形图中角膜屈光力、散光和不规则度(表面规则性和不对称指数)的时间进程变化。

结果

对562只眼睛进行了翼状胬肉切除术,其中1级、2级和3级分别有119只、338只和105只眼睛。1级角膜不规则度无变化,除6个月时角膜散光外,1级和2级之间无差异。3级在3个月和6个月时分别显示出比1级显著更高的角膜屈光力和不规则度,而角膜散光在12个月内更高。

结论

原发性翼状胬肉切除术后的地形图变化与胬肉大小有关。越过瞳孔区域的翼状胬肉需要6至12个月才能使角膜地形图恢复,导致视力恢复缓慢。

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