International Journal of Ophthalmology & Visual Science

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Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft

Received: 19 November 2019    Accepted: 16 December 2019    Published: 24 December 2019
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Abstract

Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.

DOI 10.11648/j.ijovs.20190404.19
Published in International Journal of Ophthalmology & Visual Science (Volume 4, Issue 4, December 2019)
Page(s) 106-110
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Phacoemulsification, Pterygium, Conjunctival Autograft

References
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[2] Kwok LS, Coroneo MT et al. A model for pterygium formation. Cornea 1994; 13: 219-24.
[3] Cameron ME et al: Pterygium throughout the world. Springfield, Charles C Thomas, 1965, pp 141-171.
[4] Hiller R, Giacometti L, Yuen K et al (1977) Sunlight and cataract: an epidemiologic investigation. Am J Epidemiol 105 (5): 450–459.
[5] Hollows F, Moran D et al (1981) Cataract—The ultraviolet risk factor. Lancet 2 (8258): 1249–1250.
[6] Huchbaum DR, Moskowitz SE, Wirtschafter JD et al: A quantitative analysis of astigmatism induced by pterygium. J Biomech 10: 735746, 1977.
[7] Lim R, Mitchell P, Cumming RG et al. Cataract associations with pinguecula and pterygium: the Blue Mountains Eye Study. Am J Ophthalmol. 1998; 126: 717–719.
[8] Ibechukwu BI et al. Simultaneous pterygium and intraocular surgery. Br J Ophthalmol. 1990; 74: 265–266.
[9] Gulani A, Dastur YK et al. Simultaneous pterygium and cataract surgery. J Postgrad Med. 1995; 41: 8–11.
[10] Kodavoor SK, Ramamurthy D, Tiwari NN, Ramamurthy S et al. Double-head pterygium excision with modified vertically split-conjunctival autograft: Six-year long-term retrospective analysis. Indian J Ophthalmol 2017; 65: 700-4.
[11] Kamiya, Kazutaka MD, PhD; Shimizu, Kimiya MD, PhD et al. Predictability of Intraocular Lens Power Calculation After Simultaneous Pterygium Excision and Cataract Surgery. Medicine, December 2015 - Volume 94 - Issue 52 - p e2232.
[12] Cinal A, Yasar T, Demirok A, et al. The effect of pterygium surgery on corneal topography. Ophthalmic Surg Lasers. 2001; 32: 35–40.
[13] Yasar T, Ozdemir M, Cinal A, et al. Effects of fibrovascular traction and pooling of tears on corneal topographic changes induced by pterygium. Eye (Lond). 2003; 17: 492–496.
[14] Errais K, Bouden J, Mili-Boussen I, et al. Effect of pterygium surgery on corneal topography. Eur J Ophthalmol. 2008; 18: 177–181.
[15] Wu PL, Kuo CN, Hsu HL, et al. Effect of pterygium surgery on refractive spherocylinder power and corneal topography. Ophthalmic Surg Lasers Imaging. 2009; 40: 32–37.
[16] Nejima R, Masuda A, Minami K, et al. Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic restoration. Eye Contact Lens. 2015; 41: 58–63.
[17] Kim SW, Park S, Im CY, et al. Prediction of mean corneal power change after pterygium excision. Cornea. 2014; 33: 148–153.
[18] Tomidokoro A, Miyata K, Sakaguchi Y, et al. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology. 2000; 107: 1568–1571.
[19] Koc M, Uzel MM et al, Pterygium size and effect on intraocular lens power calculation. J Cataract Refract Surg. 2016 Nov; 42 (11): 1620-1625.
[20] Gumus, Koray & I. Tung, Cynthia & Al-Mohtaseb, Zaina et al (2017). Management of Pterygium with Coexisting Cataract. 10.5005/jp/books/13069_21.
Author Information
  • Cornea Services, the Eye foundation, Coimbatore, India

  • Cornea Services, the Eye foundation, Coimbatore, India

  • Cataract and Refractive Services, the Eye Foundation, Coimbatore, India

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    Shreesha Kumar Kodavoor, Soundarya B, Ramamurthy Dandapani. (2019). Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft. International Journal of Ophthalmology & Visual Science, 4(4), 106-110. https://doi.org/10.11648/j.ijovs.20190404.19

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    Shreesha Kumar Kodavoor; Soundarya B; Ramamurthy Dandapani. Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft. Int. J. Ophthalmol. Vis. Sci. 2019, 4(4), 106-110. doi: 10.11648/j.ijovs.20190404.19

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    AMA Style

    Shreesha Kumar Kodavoor, Soundarya B, Ramamurthy Dandapani. Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft. Int J Ophthalmol Vis Sci. 2019;4(4):106-110. doi: 10.11648/j.ijovs.20190404.19

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  • @article{10.11648/j.ijovs.20190404.19,
      author = {Shreesha Kumar Kodavoor and Soundarya B and Ramamurthy Dandapani},
      title = {Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {4},
      number = {4},
      pages = {106-110},
      doi = {10.11648/j.ijovs.20190404.19},
      url = {https://doi.org/10.11648/j.ijovs.20190404.19},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijovs.20190404.19},
      abstract = {Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft
    AU  - Shreesha Kumar Kodavoor
    AU  - Soundarya B
    AU  - Ramamurthy Dandapani
    Y1  - 2019/12/24
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijovs.20190404.19
    DO  - 10.11648/j.ijovs.20190404.19
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 106
    EP  - 110
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20190404.19
    AB  - Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.
    VL  - 4
    IS  - 4
    ER  - 

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