International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Evaluation of the effect of pterygium size on corneal astigmatism before and after excision

Dr. Abuzar Parray, Dr. Nupur Suman, Dr. Pushpalata Chaturvedi, Dr. Ruchi Saxena, Dr. Jyostna, Dr. Abhishek Kumar

Department of Ophthalmology, Saraswathi Institute of Medical Science, Hapur, Uttar Pradesh, India; Head of Department, Department of Ophthalmology, Saraswathi Institute of Medical Science, Hapur, Uttar Pradesh, India; Associate Professor, Department of Ophthalmology, Saraswathi Institute of Medical Science, Hapur, Uttar Pradesh, India; Assistant Professor, Department of Ophthalmology, Saraswathi Institute of Medical Science, Hapur, Uttar Pradesh, India

Article Information

Volume / Issue6 / 3 (July-September 2025)
Pages235-241
AccessOpen Access

Publication Timeline

  • Received10 July 2025
  • Accepted11 August 2025
  • Published

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Abstract

Pterygium is a common ocular surface disorder characterized by fibrovascular tissue growth from the conjunctiva onto the cornea, frequently causing corneal astigmatism that can significantly impact visual acuity and quality of life. This prospective study aimed to evaluate the relationship between pterygium size and the degree of corneal astigmatism before and after surgical excision, and to assess the visual outcomes following pterygium removal. A total of 180 patients with primary pterygium were enrolled and categorized into three groups based on pterygium size: small (n=60, <2mm from limbus), medium (n=65, 2-4mm from limbus), and large (n=55, >4mm from limbus). All patients underwent comprehensive ophthalmic examination including corneal topography, keratometry, and visual acuity assessment before and at 1, 3, and 6 months after pterygium excision with conjunctival autograft transplantation. Preoperatively, corneal astigmatism increased significantly with pterygium size, with mean values of 1.2±0.4 D, 2.8±0.7 D, and 4.6±1.2 D for small, medium, and large pterygia, respectively (p<0.001). Following surgical excision, significant reduction in corneal astigmatism was observed in all groups at 6 months postoperatively, with reductions of 0.8±0.3 D, 2.1±0.6 D, and 3.4±1.0 D for small, medium, and large pterygia, respectively (all p<0.001). The percentage reduction in astigmatism was greatest in the large pterygium group (73.9%) compared to medium (75.0%) and small (66.7%) groups. Best-corrected visual acuity improved significantly in all groups, with the greatest improvement observed in patients with large pterygia (from 0.45±0.12 to 0.08±0.05 logMAR, p<0.001). Corneal topographic analysis revealed that with-the-rule astigmatism was most common in all groups, and the axis of astigmatism remained relatively stable after surgery. The study demonstrates a strong positive correlation between pterygium size and preoperative corneal astigmatism (r=0.84, p<0.001), and confirms that surgical excision effectively reduces corneal astigmatism, with larger pterygia showing greater absolute reduction but similar percentage improvement. These findings support the recommendation for early surgical intervention in pterygium cases to minimize corneal distortion and optimize visual outcomes.

Keywords

PterygiumCorneal AstigmatismKeratometryCorneal TopographyPterygium ExcisionConjunctival AutograftVisual AcuityCorneal Curvature

References

  1. Liu L, Wu J, Geng J, Yuan Z, Huang D. Geographical prevalence and risk factors for pterygium: a systematic review and meta -analysis. BMJ Open. 2013;3(11):e003787. [Google Scholar][Crossref]
  2. Coroneo MT, Di Girolamo N, Wakefield D. The pathogenesis of pterygia. Curr Opin Ophthalmol. 1999;10(4):282-8. [Google Scholar][Crossref]
  3. Chui J, Coroneo MT, Tat LT, Crouch R, Wakefield D, Di Girolamo N. Ophthalmic pterygium: a stem cell disorder with premalignant features. Am J Pathol. 2011;178(2):817-27. [Google Scholar][Crossref]
  4. Maheshwari S. Effect of pterygium excision on pterygium induced astigmatism. Indian J Ophthalmol. 2003;51(2):187-8. [Google Scholar][Crossref]
  5. Tomidokoro A, Miyata K, Sakaguchi Y, Samejima T, Tokunaga T, Oshika T. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology. 2000;107(8):1568-71. [Google Scholar][Crossref]
  6. Stern GA, Lin A. Effect of pterygium excision on induced corneal topographic abnormalities. Cornea. 1998;17(1):23-7. [Google Scholar][Crossref]
  7. Walland MJ, Stevens JD, Steele AD. The effect of recurrent pterygium on corneal topography. Cornea. 1994;13(6):463-7. [Google Scholar][Crossref]
  8. Bahar I, Loya N, Weinberger D, Avisar R. Effect of pterygium surgery on corneal topography: a prospective study. Cornea. 2004;23(2):113-7. [Google Scholar][Crossref]
  9. Yagmur M, Ozcan AA, Sari S, Ersoz TR. Visual acuity and corneal topographic changes related with pterygium surgery. J Refract Surg. 2005;21(2):166-70. [Google Scholar][Crossref]
  10. Avisar R, Loya N, Yassur Y, Weinberger D. Pterygium-induced corneal astigmatism. Isr Med Assoc J. 2000;2(1):14-5. [Google Scholar][Crossref]
  11. Oldenburg JB, Garbus J, McDonnell JM, McDonnell PJ. Conjunctival pterygia. Mechanism of corneal topographic changes. Cornea. 1990;9(3):200-4. [Google Scholar][Crossref]
  12. Tan DT, Chee SP, Dear KB, Lim AS. Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol. 1997;115(10):1235-40. [Google Scholar][Crossref]
  13. Prabhasawat P, Barton K, Burkett G, Tseng SC. Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision. Ophthalmology. 1997;104(6):974-85. [Google Scholar][Crossref]
  14. Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 1985;92(11):1461-70. [Google Scholar][Crossref]
  15. Kheirkhah A, Hashemi H, Adelpour M, Nikdel M, Rajabi MB, Behrouz MJ. Randomized trial of pterygium surgery with mitomycin C application using conjunctival autograft versus conjunctival-limbal autograft. Ophthalmology. 2012;119(2):227-32. [Google Scholar][Crossref]
  16. Hirst LW. The treatment of pterygium. Surv Ophthalmol. 2003;48(2):145-80. [Google Scholar][Crossref]
  17. Hansen A, Norn M. Astigmatism and surface phenomena in pterygium. Acta Ophthalmol (Copenh). 1980;58(2):174-81. [Google Scholar][Crossref]
  18. Yanyali A, Talu H, Alp B, Karabas L. Corneal topographic changes after pterygium excision with conjunctival autograft. Ophthalmic Surg Lasers. 2001;32(6):445-50. [Google Scholar][Crossref]
  19. Ozdemir M, Cinal A. Early and late effects of pterygium surgery on corneal topography. Ophthalmic Surg Lasers Imaging. 2005;36(6):451-6. [Google Scholar][Crossref]
  20. Fong KS, Balakrishnan V, Chionh SB, Htoon HM, Chia A, Kredel L, et al. Refractive change following pterygium surgery: the PETRA study. Eye (Lond). 2014;28(11):1288-94. [Google Scholar][Crossref]
  21. Teo CHY, Riau AK, Mosadeghi P, Lwin NC, Angunawela RI, Yam GHF, et al. Corneal matrix changes following pterygium excision surgery: a prospective study. Invest Ophthalmol Vis Sci. 2016;57(12):5004-12. [Google Scholar][Crossref]
  22. Lin A, Stern GA. Correlation between pterygium size and induced corneal astigmatism. Cornea. 1998;17(1):28-30. [Google Scholar][Crossref]
  23. Tan DT, Lim AS, Goh HS, Smith DR. Abnormal expression of the p53 tumor suppressor gene in the conjunctiva of patients with pterygium. Am J Ophthalmol. 1997;123(3):404-5. [Google Scholar][Crossref]
  24. Montalban R, Pinero DP, Javaloy J, Alio JL. Correlation between corneal astigmatism and pterygium surface area. Cornea. 2013;32(11):1453-8. [Google Scholar][Crossref]
  25. Young RD, Liskova P, Pinali C, Palka BP, Palos M, Jirsova K, et al. Large proteoglycan complexes and disturbed collagen architecture in the corneal extracellular matrix of mucopolysaccharidosis type VII (Sly syndrome). Invest Ophthalmol Vis Sci. 2011;52(9):6720-8. [Google Scholar][Crossref]
  26. Errais K, Bouthour W, Ouertani A. Effect of pterygium surgery on corneal topography and corneal astigmatism. Eur J Ophthalmol. 2008;18(2):177-81. [Google Scholar][Crossref]
  27. Maheshwari S. Pterygium-induced corneal refractive changes. Indian J Ophthalmol. 2007;55(5):383-6. [Google Scholar][Crossref]

How to Cite

Parray, A., Suman, N., Chaturvedi, P., Saxena, R., Jyostna, & Kumar, A. (2025). Evaluation of the effect of pterygium size on corneal astigmatism before and after excision. International Journal of Medical and All Body Health Research, 6(3), 235-241. https://doi.org/10.54660/IJMBHR.2025.6.3.235-241

Parray, Abuzar, et al. "Evaluation of the effect of pterygium size on corneal astigmatism before and after excision." International Journal of Medical and All Body Health Research, vol. 6, no. 3, 2025, pp. 235-241. https://doi.org/10.54660/IJMBHR.2025.6.3.235-241.

Parray, A., Suman, N., Chaturvedi, P., Saxena, R., Jyostna and Kumar, A. (2025) 'Evaluation of the effect of pterygium size on corneal astigmatism before and after excision', International Journal of Medical and All Body Health Research, 6(3), pp. 235-241. doi: 10.54660/IJMBHR.2025.6.3.235-241.

Parray A, Suman N, Chaturvedi P, Saxena R, Jyostna, Kumar A. Evaluation of the effect of pterygium size on corneal astigmatism before and after excision. International Journal of Medical and All Body Health Research. 2025;6(3):235-241. doi:10.54660/IJMBHR.2025.6.3.235-241

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