Julio Gemma, Campos Pamela, Pujol Pere, Munguia Aitana, Mas-Aixala Enric
*Ocular Surface Research Group, Optics and Optometry Department, Universitat Politècnica de Catalunya-Barcelona Tech, Terrassa, Barcelona, Spain; and†Department of Ophthalmology, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain.
Cornea. 2016 Dec;35(12):1594-1599. doi: 10.1097/ICO.0000000000000932.
To establish determining factors for fast corneal sensitivity (CS) recovery after pterygium excision.
Thirty-two eyes of 14 males and 18 females with primary nasal pterygium were recruited. Differences in CS (in the 4 quadrants and the center using a Cochet-Bonnet esthesiometer), pterygium corneal area (PCA), tear osmolarity, tear break-up time, Schirmer test, and ocular symptoms were analyzed before and 1 month after lesion excision. The relationship between CS recovery (difference between the 2 time points; CS1 - CS0) and the other features was assessed.
All the studied locations exhibited normal (6 cm) or near-normal mean CS at the 2 time points, except a tendency for moderate hypoesthesia in nasal CS0 (median 4.5; range: 1.5-6.0 cm). Point by point comparison revealed significant postoperative improvements in nasal location (P = 0.008; Wilcoxon signed-rank test) with normal values in 17 eyes (53%) and a median CS1 = 5.0 cm (2.5-5.5 cm) in 15 eyes with no complete recovery. No significant correlation was found between CS0 and the studied variables, and CS1 was only significantly correlated with PCA (rho: -0.441; P < 0.05). CS recovery also showed significant correlation with PCA (rho = -0.516; P < 0.01).
CS recovery after pterygium excision showed important variability, and the only studied factor that seems to be determinant could be PCA. It would be advisable to operate when the lesion is relatively small, with lower surgical injury and faster and complete recovery, thus protecting ocular surface homeostasis.
确定翼状胬肉切除术后角膜敏感性（CS）快速恢复的决定因素。
招募了14名男性和18名女性的32只患有原发性鼻侧翼状胬肉的眼睛。在病变切除前和切除后1个月，分析CS（使用Cochet-Bonnet感觉计在4个象限和中央测量）、翼状胬肉角膜面积（PCA）、泪液渗透压、泪膜破裂时间、Schirmer试验和眼部症状的差异。评估CS恢复情况（两个时间点之间的差异；CS1 - CS0）与其他特征之间的关系。
除鼻侧CS0有中度感觉减退倾向（中位数4.5；范围：1.5 - 6.0 cm）外，所有研究部位在两个时间点的平均CS均正常（6 cm）或接近正常。逐点比较显示鼻侧部位术后有显著改善（P = 0.008；Wilcoxon符号秩检验），17只眼（53%）CS值恢复正常，15只眼未完全恢复，CS1中位数为5.0 cm（2.5 - 5.5 cm）。未发现CS0与研究变量之间有显著相关性，CS1仅与PCA显著相关（rho：-0.441；P < 0.05）。CS恢复也与PCA显著相关（rho = -0.516；P < 0.01）。
翼状胬肉切除术后CS恢复存在重要差异，唯一似乎起决定作用的研究因素可能是PCA。当病变相对较小时进行手术是可取的，这样手术损伤较小，恢复更快且更完全，从而保护眼表稳态。
