Objective To evaluate the effect of pterygium surgery on corneal topography by comparing wave front analysis before and one month after the surgical treatment. Methodology Fifty eyes of forty-one patients were included in this study. Twenty five male and sixteen female patients seeking pterygium surgery were recruited from the Ophthalmology Department Outpatient Clinic in Sohag Teaching Hospital during the period from July 2017 to May 2018. All eyes underwent pterygium excision with conjunctival autograft. Results In this study we found a highly statistically significant improvement in the mean uncorrected visual acuity from 0.44±0.21SD preoperatively to 0.62±0.18SD postoperatively (p < 0.001) and a highly statistically significant difference in the mean logMAR visual acuity as it was decreased from 0.43±0.28 SD preoperatively to 0.34±0.23 SD postoperatively (p < 0.001). Also, there was a highly statistically significant improvement in mean of manifest refractive astigmatism from -4.08±3.28 SD preoperatively to -1.46±1.40 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean cycloplegic astigmatism from -4.00±3.01 SD preoperatively to -1.39±1.33 SD postoperatively (p < 0.001) and also there was a highly statistically significant improvement in the mean topographic astigmatism from -5.17±4.08 SD preoperatively to -2.20±2.31 SD postoperatively (p < 0.001). We also found a highly statistically significant improvement in the mean of ISV (Index of Surface Variance) from 76.22±36.86 SD preoperatively to 33.56±15.02 SD post operatively (p < 0.001) and also there was a highly statistically significant improvement in the mean IHD (Index of Height Decentration) from 0.042±0.027SD pre-operatively to 0.023±0.036 SD post operatively. Conclusion There was a highly statistically significant difference in the mean logMAR visual acuity and a highly statistically significant improvement in the mean uncorrected visual acuity. A highly statistically significant improvement in both refractive and topographic astigmatism after one month of the surgery was noted also. Here were also a highly statistically significant improvement in ISV and IHD that indicate improvement after pterygium removal. Recommendations Patient with pterygium that inducing astigmatism will benefit from surgical removal of the pterygium.
Background Retinopathy is a common and specific microvascular complication of diabetes. Clinical and experimental findings suggested that choroidal vasculopathy in diabetes may play a role in the pathogenesis of diabetic retinopathy. Spectral-domain optical coherence tomography (SD-OCT) can analyze choroidal structure and histopathological changes in diabetes. Purpose To compare choroidal thickness (CT) before and after panretinal photocoagulation (PRP), modified grid laser (MGP) and combined (panretinal photocoagulation & modified gird laser) using SD-OCT. Design Comparative prospective non-randomized case study, included 30 eyes of 30 patients from both sexes aging from 15 to 60 years. All patients were from Ain-Shams University Hospitals outpatient clinics. Patients were divided into 3 equal groups: Group A Patients with PDR underwent PRP, Group B: Patients with macular edema (ME) underwent MGP, Group C: Patients with PDR&ME underwent combined (PRP & MGP). All cases underwent SD-OCT with CT measurement before and at 1 & 3 Mns after laser therapy with assessment of best corrected visual acuity (BCVA). Results Mean age of participant was 50.83 ± 5.34 (SD). The mean CT in group A at baseline was 329.00 ± 36.08 μm (SD). This was increased to 336.40 ± 35.64 μm at 1 month then was decreased to 309.10 ± 38.87 μm at 3 Mns after laser therapy. This was showed highly statistically significant difference (P-value = 0.000). In group B the CT at baseline was 328.90 ± 19.69 μm. This was decreased to 313.90 ± 17.83 μm & 288.90 ± 23.10 μm after 1 & 3 months respectively with highly statistically significant difference (P-value = 0.000). While in group C the mean CT at baseline 329.80 ± 21.06 μm. This was decreased to 318.10 ± 19.25 μm, 300.40 ± 17.98 μm at 1 & 3 months after combined laser respectively. This was showed highly statistically significant difference (P-value = 0.000). There was no statistically significant difference between the studied groups regarding preoperative and postoperative (after 1&3 Mns) CT. There was no statistically significant difference observed between the studied groups regarding preoperative BCVA (P-value = 0.437). While P-value showing highly statistically significant difference between the studied groups regarding postoperative BCVA (P-value = 0.000). Conclusion The Choroidal thickness decreased in all 3 studied groups; suggesting that all laser techniques may reduce choroidal vascular permeability or cause atrophy of choroidal vessels over a 12-week period.
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