Niruthisard Duangratn, Tulvatana Wasee, Satitpitakul Vannarut
Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Center of Excellence for Cornea and Stem Cell Transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Clin Ophthalmol. 2021 Mar 25;15:1277-1283. doi: 10.2147/OPTH.S303936. eCollection 2021.
To determine the percentage of eyes with corneal astigmatic power stability and mean corneal keratometric power at 6-month post-pterygium excision, and to identify the time, and the associated factors, required to achieve stability.
This prospective observational study enrolled patients undergoing pterygium excision. Patients were evaluated for baseline characteristics and keratometric data before and every month after pterygium excision for six months using IOL Master 500 (Carl Zeiss, Meditec). Clinically stable corneal astigmatic power and keratometric power were, respectively, defined as changes in these parameters of less than 0.25 and 0.27 diopters after two consecutive visits. Time to corneal astigmatic and keratometric power stability, as well as factors associated with the stability, were analyzed.
Forty percent and 73.3% of eyes, respectively, demonstrated corneal astigmatic and corneal keratometric stability at six months post-operation. Within three months of reaching initial stability, the corneal astigmatic power and the mean keratometric power showed instability in 46.7% and 27.3% of patients, respectively. No patients with keratometric stability for more than three months became unstable during the study period. The extension of pterygium exceeding 3.0 mm was associated with a delay in time to corneal astigmatic stability (HRadjusted 0.41; 95% CI 0.19-0.89; P= 0.02).
According to the clinical relevance, 40% and 73% of patients, respectively, presented corneal astigmatic and keratometric stability within six months post-operation. Patients with a pterygium extension of more than 3 mm required a longer time for corneal astigmatic stability. It is recommended that keratometric stability be achieved for at least three months before commencing with additional procedures.
确定翼状胬肉切除术后6个月角膜散光度数稳定的眼的百分比以及平均角膜曲率计读数，并确定实现稳定所需的时间及相关因素。
这项前瞻性观察性研究纳入了接受翼状胬肉切除术的患者。使用IOL Master 500（卡尔·蔡司医疗技术公司）在翼状胬肉切除术前及术后6个月内每月对患者进行基线特征和角膜曲率数据评估。临床上，连续两次就诊后这些参数变化小于0.25和0.27屈光度分别定义为角膜散光度数和角膜曲率计读数稳定。分析角膜散光度数和角膜曲率计读数达到稳定的时间以及与稳定相关的因素。
术后6个月分别有40%和73.3%的眼表现出角膜散光和角膜曲率稳定。在达到初始稳定后的三个月内，分别有46.7%和27.3%的患者角膜散光度数和平均角膜曲率计读数出现不稳定。在研究期间，角膜曲率稳定超过三个月的患者没有出现不稳定情况。翼状胬肉延伸超过3.0 mm与角膜散光稳定时间延迟相关（校正后风险比0.41；95%可信区间0.19 - 0.89；P = 0.02）。
根据临床相关性，分别有40%和73%的患者在术后6个月内表现出角膜散光和角膜曲率稳定。翼状胬肉延伸超过3 mm的患者角膜散光稳定所需时间更长。建议在开始额外手术前角膜曲率稳定至少三个月。
