ABSTRACT
@#AIM: To investigate the clinical effects of soft corneal contact lens after excision of pterygium and limbal stem cell transplantation in elderly patients. <p>METHODS:Totally 90 patients(90 eyes)with unilateral pterygium were divided into two groups according to the random number table method. The observation group(45 cases)were treated with soft corneal contact lens after corneal limbal autograft transplantation merely, 45 cases of the control group were treated by autologous limbal stem cell transplantation. According to the data obtained from two groups of patients, the following indicators were compared: corneal healing time, symptom score of corneal irritation in 1d, 3d, 5d, 7d after operation, postoperative 24h、48h, two groups of patients with pain(VAS score),the recurrence rate of pterygium. <p>RESULTS: In control group, the corneal healing time(5.38±1.67d)was more than that of observation group(3.10±1.12d; <i>P</i><0.05); Score of the corneal stimulation symptom and VAS after operation were higher than those of the control group(<i>P</i><0.05), and the difference in recurrence of pterygium was not statistically significant(<i>P</i>>0.05).<p>CONCLUSION: Autologous corneal stem cells combined with soft corneal contact lens in treatment of elderly patients with pterygium can reduce the healing time, and reduce the postoperative symptom of corneal irritation, meanwhile it has no effect on the recurrence rate of pterygium.
ABSTRACT
PURPOSE: To investigate the types of corneal higher-order aberration (HOA) induced by pterygium, residual corneal HOA after pterygium surgery, and correlations between corneal HOA and the length of the pterygium. METHODS: Fifty-three patients who underwent pterygium excision with conjunctival autograft were enrolled. Corneal HOA was measured by Pentacam® (Oculus Inc., Wetzlar, Germany) preoperatively and 3 months postoperatively in the 6-mm optical zone. Preoperative and postoperative HOAs of eyes with pterygium were compared with HOAs of the fellow eye to evaluate HOAs induced by pterygium and residual HOAs after pterygium surgery. Partial correlation analysis was performed to investigate the relationship between HOAs and the length of pterygium. A postoperative HOA less than 0.35 µm in size was defined as a favorable surgical outcome and the surgical indications were estimated using receiver operator characteristic (ROC) curve. RESULTS: Horizontal coma, root mean square (RMS) of coma, oblique trefoil, horizontal trefoil, RMS of trefoil, and total HOA were significantly greater in the eye with preoperative pterygium. Three months after pterygium excision, only RMS of coma and total HOA remained significantly greater in eyes with pterygium. Vertical coma, horizontal coma, RMS of coma, and oblique tetrafoil were correlated with pterygium length. Pterygium excision when pterygium length was less than 1.6 mm led to favorable surgical outcomes. CONCLUSION: Pterygium induced greater than third-order corneal HOAs and these HOAs were corrected via pterygium surgery. Longer pterygium length was associated with larger RMS of coma and larger coma RMS persisted after pterygium surgery. A pterygium length of 1.6 mm should be considered the cutoff for pterygium excision for reducing postoperative corneal HOA.