Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Phototherapeutic Keratectomy Results for the Treatment of Corneal Scarring After Pterygium Excision: A Retrospective Clinic Study
Pterjium Eksizyonu Sonrası Oluşan Ön Kornea Skarının Giderilmesi İçin Yapılan Fototerapötik Keratektomi Sonuçlarımız: Retrospektif Klinik Çalışma
Berrin UZUNOVALIa , Demet MUTLUa , Mustafa ATAŞb
aKayseri City Hospital, Clinic of Ophthalmology, Kayseri, Türkiye
bÜsküdar University Faculty of Medicine, Department of Ophthalmology, İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2025;34(1):24-30
doi: 10.5336/ophthal.2024-106629
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the post-treatment corneal changes by corneal topography in patients who underwent phototherapeutic keratectomy (PTK) to reduce anterior corneal irregularity and corneal scarring after pterygium excision. Material and Methods: One eye of 23 patients who underwent PTK was retrospectively analyzed. Corneal topography data of the patients collected after pterygium excision were compared with those obtained 1 year after PTK. Results: The mean time to PTK after pterygium excision was 5.93±1.39 months (4-9 months). No statistically significant difference was found in the topographic data of the patients at the 1st, 3rd and 6th postoperative months controls. In the 12th postoperative month results, the corrected distance visual acuity improved significantly from 0.55±0.28 logMAR (0.10-1.00 logMAR) to 0.46±0.32 logMAR (0.1-1.00 logMAR). While the K1 (flattest central keratometry) value was lower in 15 patients after PTK surgery, the difference was not statistically significant. (p=0.301). After PTK, K2 (steepest central keratometry), Kmax (maximum keratometry) and spherical equivalent values were lower than preoperative values, the difference was not statistically significant (respectively p=0.060, p=0.075, p=0.570). In 17 patients, the postoperative index of vertical asymmetry value was higher than before the operation, and the difference was statistically significant (p=0.014). Although index of surface variance, index of height asymmetry and index of height decentrization values were higher than before surgery, the differences were not statistically significant (respectively p=0.988, p=0.543, p=0.181). Conclusion: PTK improves corrected visual acuity by reducing corneal surface irregularity and spectacle-corrected astigmatism following pterygium excision.

Keywords: Pterygium; corneal topography; keratectomy; corneal laser surgery
ÖZET
 Amaç: Pterjium eksizyonu sonrası ön korneal düzensizliğini ve korneal skarını azaltmak için fototerapötik keratektomi [phototherapeutic keratectomy (PTK)] uygulanan hastalarda, tedavi sonrası korneal değişiklikleri kornea topografisi ile değerlendirmektir. Gereç ve Yöntemler: PTK uygulanan 23 hastanın bir gözü retrospektif olarak analiz edilmiştir. Hastaların pterjium cerrahisi sonrası toplanan kornea topografi verileri, PTK'den 1 yıl sonra elde edilen verilerle karşılaştırılmıştır. Bulgular: Pterjium eksizyonu sonrası PTK uygulanma süresi ortalama 5,93±1,39 ay (4-9 ay) idi. Ameliyat sonrası 1, 3 ve 6. ay kontrollerinde hastaların topografik verilerinde istatistiksel olarak anlamlı bir fark bulunmamıştır. Ameliyat sonrası 12. ay sonuçlarında ise düzeltilmiş uzak görme keskinliği, 0,55±0,28 logMAR (0,10-1,00 logMAR) değerinden 0,46±0,32 logMAR (0,1-1,00 logMAR) değerine anlamlı bir şekilde iyileşmiştir. On beş hastada K1 (düz merkezi keratometri) değeri daha düşük olmasına rağmen, fark istatistiksel olarak anlamlı değildi (p=0,301). Ameliyat sonrası K2 (dik merkezi keratometri), Kmax (maksimum keratometri) ve sferik eş değer değerleri ameliyat öncesi değerlere göre daha düşük olmakla birlikte, fark istatistiksel olarak anlamlı değildi (sırasıyla p=0,060, p=0,075, p=0,570). On yedi hastada ameliyat sonrası vertikal asimetri indeksi değeri ameliyat öncesine göre daha yüksek bulunmuş olup, fark istatistiksel olarak anlamlıydı (p=0,014). Yüzey varyans indeksi, yükseklik asimetrisi indeksi ve yükseklik desantralizasyon indeksi değerleri ameliyat öncesine göre yüksek olmasına rağmen fark istatistiksel olarak anlamlı değildi (sırasıyla p=0,988, p=0,543, p=0,181). Sonuç: PTK, pterjium eksizyonu sonrası korneal yüzey düzensizliğini ve gözlükle düzeltilebilir astigmatizmayı azaltarak düzeltilmiş görme keskinliğinin artmasını sağlar.

Anahtar Kelimeler: Pterjium; kornea topografisi; keratektomi; kornea lazer cerrahisi
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