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

S. Kodavoor, B. Soundarya, R. Dandapani
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引用次数: 1

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.
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自体结膜植入术联合超声乳化术和翼状胬肉切除术后的视力和屈光效果
目的:本研究旨在分析自体结膜植入术(CAG)联合超声乳化术和翼状胬肉切除术后的视力和屈光结果。环境——印度南部的三级眼科医院。设计回顾性研究。方法纳入2011-2017年同期行超声乳化术合并翼状胬肉切除术的508只眼。排除标准-术前散光> 2d, 3级翼状胬肉,复发或双头翼状胬肉,外伤性或并发性白内障。术前评估-临床检查,角膜测量,人工晶状体度数计算,视网膜检查和主观屈光。手术步骤:可折叠单焦点人工晶状体超声乳化术,翼状胬肉切除,自体结膜组织胶植入术。术后随访-定期随访6个月。结果-平均术前最佳矫正视力(LogMAR)为0.41+/-0.46,术后平均为0.04+/-0.12 (p=0.001)。术前、术后平均散光分别为-1.25+/-0.60 D和-0.73+/-0.58 D (p=0.001)。术后平均近视球面误差为-0.85+/-0.48 d,术后屈光不正占34.33%,其中近视占87.42%,远视误差(<1D)占12.57%。63.27%的近视误差小于1 d。最常见的并发症是结膜下出血,术后移植物缩回分别为12眼和10眼。结论:单步超声乳化术联合翼状胬肉切除手术安全有效,视力良好。对并发翼状胬肉患者,可通过略低于人工晶状体度数的矫正来预测和减少术后近视残留误差,使视力达到最佳。
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