Chikkanayakanahalli Narasimhaiah Pinto, Gupta Shikha, Khokhar Sudarshan, Vanathi Murugesan, Dada Tanuj, Pandey Ravinder M, Agarwal Tushar
Cornea and Refractive Services (C.N.P., S.G., S.K., M.V., T.D., T.A.), Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and Department of Biostatistics (R.M.P.), All India Institute of Medical Sciences, New Delhi, India.
Eye Contact Lens. 2015 Sep;41(5):268-72. doi: 10.1097/ICL.0000000000000115.
To evaluate outcomes of motorized diamond burr polishing versus manual polishing after pterygium excision.
Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi.
A randomized, interventional observer-masked controlled trial.
Forty consecutive eyes underwent pterygium excision with fibrin, glue-assisted conjunctival autograft. In group 1 (20 eyes), polishing of the corneal bed was done using a crescent blade, and in group 2 (20 eyes), using a motorized diamond burr.
There was no difference in the 2 groups with respect to mean age (P=0.08), gender (P=0.3), preoperative uncorrected visual acuity (UCVA) (P=0.45), best spectacle-corrected visual acuity (BCVA) (P=0.52), spherical equivalent (P=0.5), mean astigmatism (P=0.7), tear function tests like tear break-up time, tear film meniscus height, Schirmer I and II (P=0.6, 0.5, 0.7, 0.9 respectively), pterygium dimension (P=0.4), and conjunctival autograft size (P=0.24). Mean intraoperative surgical time was significantly more in group 1 (16.9 ± 2.85 min) as compared with 12.25 ± 1.88 min in group 2 (P=0.0001). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, Schirmer I and II, and tear meniscus height at 6 months between 2 groups; however, significantly better UCVA was found in group 2 at 3 months (P=0.04). Surgically induced astigmatism (SIA) was significantly more in group 2 as compared with group 1 at 6 months (P=0.0006).
Motorized diamond burr polishing of the corneoscleral bed during primary pterygium excision in comparison with manual polishing requires significantly lesser surgical time with better UCVA, decreased astigmatism, and greater SIA at 6 months, which indicates greater astigmatic correction.
评估翼状胬肉切除术后电动金刚石磨头抛光与手动抛光的效果。
新德里拉金德拉·普拉萨德眼科科学中心。
一项随机、干预性、观察者盲法对照试验。
连续40只眼接受了翼状胬肉切除联合纤维蛋白、胶水辅助结膜自体移植术。第1组（20只眼）使用月牙形刀片对角膜床进行抛光，第2组（20只眼）使用电动金刚石磨头进行抛光。
两组在平均年龄（P = 0.08）、性别（P = 0.3）、术前未矫正视力（UCVA）（P = 0.45）、最佳矫正视力（BCVA）（P = 0.52）、等效球镜度（P = 0.5）、平均散光（P = 0.7）、泪液功能测试如泪膜破裂时间、泪膜半月高度、Schirmer I和Schirmer II（分别为P = 0.6、0.5、0.7、0.9）、翼状胬肉大小（P = 0.4）以及结膜自体移植片大小（P = 0.24）方面无差异。第1组平均术中手术时间（16.9 ± 2.85分钟）明显长于第2组的12.25 ± 1.88分钟（P = 0.0001）。术后，所有眼的散光均有统计学意义的降低，UCVA、BCVA、等效球镜度均有改善。两组在6个月时的平均上皮缺损愈合时间、UCVA、BCVA、散光、泪膜破裂时间、Schirmer I和Schirmer II以及泪膜半月高度方面无差异；然而，第2组在3个月时的UCVA明显更好（P = 0.04）。第2组在6个月时的手术源性散光（SIA）明显高于第1组（P = 0.0006）。
与手动抛光相比，原发性翼状胬肉切除术中使用电动金刚石磨头对角膜巩膜床进行抛光所需手术时间明显更短，UCVA更好，散光降低，6个月时SIA更大，这表明散光矫正效果更佳。
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