Introduction: Pterygium is a common surface disorder of the eye that may cause change in visual acuity of patients by inducing astigmatic refractive error. Surgical excision with grafting is considered the most effective recommended treatment for pterygium. The objective of this study was to evaluate the outcomes of pterygium excision with autologous graft surgery on keratometric astigmatism and visual acuity. Materials and methods: In this study total 64 eyes of 64 patients were enrolled having the diagnosis of pterygium. Prior to the pterygium excision surgery all the enrolled patients were studied for grading of pterygium, clinical symptoms, keratometric values and best corrected visual acuity (BCVA). Postoperatively, BCVA and keratometric readings were recorded at one week, one month, two months and four months intervals. Results: Mean age of study participants was 34.16 ± 8.24 years in the age group of 18-60 years. 42 (65.62%) eyes had grade II pterygium, while 16 (25.0 %) and 6 (9.38%) eyes were having grade III and grade IV pterygium, respectively. Preoperative median and quartiles (25% -75%) horizontal and vertical keratometric values were 43.00 (42.50-44.00) D and 44.25 (43.75-44.50) D, respectively and both reduced significantly to 42.50 (42.50-42.94) D and 42.50 (42.50- 43.00) D, respectively after four months postoperatively. Median keratometric astigmatism before surgery was 1.37 (1.25-1.93) D which reduced significantly to 0.50 (0.32-0.75) D after four months of pterygium excision. Similarly, BCVA improved significantly [0.20(0.16-0.25) vs 0.53 (0.50-0.80)] when assessed postoperatively after four months. Conclusion: Excision of pterygium with autologous graft reduced pterygium-induced keratometric astigmatism and improved BCVA significantly.
Aims: To evaluate the clinical and histological status of tear film in patients with unilateral pterygium. Settings and Design:Cross-sectional, case-control, doubleblinded study. Methods and Material:Cross-sectional study of both eyes of 102 patients with unilateral pterygium was conducted between March 2011 to December 2012. Patients were subject to fluorescein lower tear meniscus height (LTMH) evaluation, fluorescein tear break-up time (TBUT), Schirmer's test (using topical anesthetic), vital staining (viz. fluorescein, Rose Bengal and lissamine staining), LTMH imaging with anterior segment spectral-domain optical coherence tomography (OCT) cornea-anterior module (CAM-L and CAM-S), and conjunctival smear impression cytology. The normal eye acted as control. Statistical analysis used: fisher's t-test and chi-square test.Results: The study comprised of seventy males and thirtytwo females in the age-range 28-76years. The mean fluorescein LTMH, mean TBUT, mean Schirmer's test value, mean OCT CAM-S and CAM-L values in the normal control eyes were 0.36 ± 0.03 mm, 12.3 ± 1.9s, 13.4 ± 2.5 mm, 0.338 ± 0.082 mm and 0.325 ± 0.088 mm, respectively. The comparable values in eyes with pterygium were 0.24 ± 0.03 mm, 8.2 ± 1.4 sec, 9.2 ± 2.4 mm, 0.212 ± 0.046 mm and 0.204 ± 0.058 mm respectively. Goblet cell count was decreased in impression cytology. Conclusions:Both fluorescein and OCT LTMH were found to be significantly decreased (p<0.01) in eyes with pterygium compared to control eyes. Goblet cell count, TBUT and Schirmer's test values were also comparatively decreased. This study thus emphasizes that tear film abnormalities play a role in aetiology of pterygium and hence early institution of therapy for tear film stabilization can help prevent the disease. Keywords: Keymessage:This study emphasizes that tear film abnormalities play a role in aetiology of pterygium and hence early institution of therapy for tear film stabilization can help prevent the disease.
Introduction: Dry eye (keratoconjunctivitis sicca) is a common disorder of the tear film having multifactorial aetiology. Now-a-days, a large portion of population is affected with Dry Eye Disease (DED) because of substantial increase in usage of computers and digital devices. Aim: To evaluate the effect of varying durations of computer usage on parameters of DED. Materials and Methods: In this prospective study, total 120 participants were divided into two groups. Group I (n=58) included participants who used computer daily for less than six hours while group II (n=62) included those who used computer for more than six hours daily. Routine eye examination was done and dry eye parameters i.e., Ocular Surface Diseases Index (OSDI), Schirmer Test (ST) and Tear Film Break Up Time (TFBUT) were performed and analysed for any significant difference between groups I and II using unpaired t-test. SPSS 16.0 was used and p-value <0.05 was considered as statistically significant. Pearson’s correlation test was performed to analyse correlation of OSDI score with TFBUT and ST values. Results: Mean OSDI scores in group I and group II were 37.39±8.98 and 49.54±11.7 (p<0.001), respectively; while TFBUT values were 10.19±2.27 seconds and 8.12±2.9 seconds (p<0.001), respectively. ST values were 12.82±3.32 mm in group I and 10.80±3.86 mm in group II (p=0.0027). Significant inverse correlation between OSDI score and TFBUT values was found in both group I (r=-0.557, p<0.001) and group II (r=-0.439, p<0.001). Similarly, correlation of OSDI score with ST values in group I (r=-0.787, p<0.001) and group II (r=-0.320, p=0.011) was also inversely significant. On the basis of OSDI score, 38 (65.5%) participants in group I and 54 (87.08%) participants in group II had severe dry eye. According to TFBUT values 12 (20.68%) participants in group I and 29 (46.77%) participants in group II and as per ST values 17 (29.31%) participants in group I and 30 (48.38%) participants in group II had severe dry eye. Conclusion: Usage of computer or digital displays more than six hours per day is a potential cause for the development of severe DED.
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