Corneal steep island formation after primary pterygium surgery.
<h4>Aims</h4>This study aimed to report corneal steep island (CSI) formation following primary pterygium surgery and to identify preoperative pterygium morphological features that predict the likelihood of CSI.<h4>Methods</h4>A total of 93 eyes from 84 subjects with primary n...
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Public Library of Science (PLoS)
2024-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0313958 |
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| author | Dong Hee Ha Kyoung Woo Kim |
| author_facet | Dong Hee Ha Kyoung Woo Kim |
| author_sort | Dong Hee Ha |
| collection | DOAJ |
| description | <h4>Aims</h4>This study aimed to report corneal steep island (CSI) formation following primary pterygium surgery and to identify preoperative pterygium morphological features that predict the likelihood of CSI.<h4>Methods</h4>A total of 93 eyes from 84 subjects with primary nasal pterygium, who underwent pterygium excision combined with conjunctival-limbal autograft, were included in this retrospective longitudinal cohort study. CSI was defined using anterior segment swept-source optical coherence tomography (AS SS-OCT). Eyes were divided into two groups: those with postoperative CSI formation (Group 1) and those without postoperative CSI (Group 2). We compared postoperative anterior corneal astigmatism (ACA, in diopters [D]) and root mean square (RMS) values of anterior corneal lower-order (LoA) and higher-order aberrations (HoA) between the groups. Baseline clinical severity grades of pterygium based on the pre-established pterygium body morphology and vascularity, ACA, and AS SS-OCT-guided pterygium morphological profiles (horizontal invasion length [HIL, mm], height [μm], thickness (μm), and residual corneal thickness [RCT]/central corneal thickness [CCT] ratio [RCT/CCT]) were also compared.<h4>Results</h4>Postoperative CSI occurred in 26 eyes (28.0%) with a maximum follow-up duration of 22.9±27.4 months. Group 1 exhibited significantly higher postoperative anterior corneal RMS LoA and HoA, as well as the RMS values of the 4th to 6th orders. Although clinical severity grades of pterygium did not differ between groups, baseline ACA was higher in Group 1 (4.56±5.49 D vs. 2.70±3.80 D, P = 0.009). HIL (4.49±0.84 mm vs. 3.77±1.29 mm, P = 0.010) was higher in Group 1, while pterygium height (930.8±84.4 μm vs. 999.3±128.0 μm, P = 0.015) and RCT/CCT ratio (1.07±0.13 vs. 1.14±0.16, P = 0.049) were lower in Group 1.<h4>Conclusions</h4>CSI may develop after primary pterygium surgery, particularly in patients with relatively higher preoperative ACA, longer HIL, and shorter height. Given that CSI can significantly increase both lower and higher-order aberrations, it is crucial to anticipate CSI probability and inform patients before surgery. |
| format | Article |
| id | doaj-art-b08f2d2be16741cd97c5ec6a54eb2a6f |
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| language | English |
| publishDate | 2024-01-01 |
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| spelling | doaj-art-b08f2d2be16741cd97c5ec6a54eb2a6f2025-08-20T02:01:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031395810.1371/journal.pone.0313958Corneal steep island formation after primary pterygium surgery.Dong Hee HaKyoung Woo Kim<h4>Aims</h4>This study aimed to report corneal steep island (CSI) formation following primary pterygium surgery and to identify preoperative pterygium morphological features that predict the likelihood of CSI.<h4>Methods</h4>A total of 93 eyes from 84 subjects with primary nasal pterygium, who underwent pterygium excision combined with conjunctival-limbal autograft, were included in this retrospective longitudinal cohort study. CSI was defined using anterior segment swept-source optical coherence tomography (AS SS-OCT). Eyes were divided into two groups: those with postoperative CSI formation (Group 1) and those without postoperative CSI (Group 2). We compared postoperative anterior corneal astigmatism (ACA, in diopters [D]) and root mean square (RMS) values of anterior corneal lower-order (LoA) and higher-order aberrations (HoA) between the groups. Baseline clinical severity grades of pterygium based on the pre-established pterygium body morphology and vascularity, ACA, and AS SS-OCT-guided pterygium morphological profiles (horizontal invasion length [HIL, mm], height [μm], thickness (μm), and residual corneal thickness [RCT]/central corneal thickness [CCT] ratio [RCT/CCT]) were also compared.<h4>Results</h4>Postoperative CSI occurred in 26 eyes (28.0%) with a maximum follow-up duration of 22.9±27.4 months. Group 1 exhibited significantly higher postoperative anterior corneal RMS LoA and HoA, as well as the RMS values of the 4th to 6th orders. Although clinical severity grades of pterygium did not differ between groups, baseline ACA was higher in Group 1 (4.56±5.49 D vs. 2.70±3.80 D, P = 0.009). HIL (4.49±0.84 mm vs. 3.77±1.29 mm, P = 0.010) was higher in Group 1, while pterygium height (930.8±84.4 μm vs. 999.3±128.0 μm, P = 0.015) and RCT/CCT ratio (1.07±0.13 vs. 1.14±0.16, P = 0.049) were lower in Group 1.<h4>Conclusions</h4>CSI may develop after primary pterygium surgery, particularly in patients with relatively higher preoperative ACA, longer HIL, and shorter height. Given that CSI can significantly increase both lower and higher-order aberrations, it is crucial to anticipate CSI probability and inform patients before surgery.https://doi.org/10.1371/journal.pone.0313958 |
| spellingShingle | Dong Hee Ha Kyoung Woo Kim Corneal steep island formation after primary pterygium surgery. PLoS ONE |
| title | Corneal steep island formation after primary pterygium surgery. |
| title_full | Corneal steep island formation after primary pterygium surgery. |
| title_fullStr | Corneal steep island formation after primary pterygium surgery. |
| title_full_unstemmed | Corneal steep island formation after primary pterygium surgery. |
| title_short | Corneal steep island formation after primary pterygium surgery. |
| title_sort | corneal steep island formation after primary pterygium surgery |
| url | https://doi.org/10.1371/journal.pone.0313958 |
| work_keys_str_mv | AT dongheeha cornealsteepislandformationafterprimarypterygiumsurgery AT kyoungwookim cornealsteepislandformationafterprimarypterygiumsurgery |