| Objective:By exploring the influence of pterygium invading the cornea size and dry eye-related indicators on visual quality(V)before and after surgery,the timing of pterygium is determined.Methods:According to the inclusion and exclusion criteria,a total of 59 cases(80 eyes)were analyze d for patients with primary pterygium admitted to our hospital from March 2020 to Decemb er 2021.There were 38 males and 42 females;the minimum age and maximum age were 29 years old and 75 years old respectively,with an average age(55.78±4.30);45 cases in the r ight eye and 35 cases in the left eye.The patients in this study were all primary pterygium with the same pathological location,all on the nose.All patients need an eye examination b efore surgical treatment,which is carried out by the same professional physician.The exam ination items include the Ocular surface disease index(OSDI)questionnaire survey,corneal astigmatism(CS),high order difference(HOD),total wavefront aberration,tear break-up T ime(BUT)and tear Meniscus height(TNH).At the same time,the length of pterygium intr usion into the cornea of patients was measured.According to the measurement results,the p atients were divided into three groups.The length of pterygium(L≤2.5mm)had 23 eyes in group A,the length of pterygium(2.5mm<L<3.0mm)had 40 eyes in group B,and the lengt h of pterygium(≥3.0mm)had 17 eyes in group C.In 80 cases,pterygium resection combine d with corneal margin stem cell transplantation was performed by the same main surgeon.P atients with eye surgery CS,HOD,total wavefront aberration,BUT and TH 1 week or 1 mo nth after follow-up.On the basis of regression analysis,the correlation between the size of pterygium and the height of CS,HOD,total wavefront aberration,BUT and tear river befor e,1 week after surgery and 1 month after surgery was studied,and the change trends of CS,HOD,total wavefront aberration,BUT and TH of patients before and 1 week and 1 month after surgery were summarized.The data is entered into the SPSS21.0 system software for c alculation,measured with(±s),counting statistics with(%),the length of pterygium invadin g cornea as a dependent variable,CS,HOD,total wavefront aberration,BUT and tear river height as independent variables,and multiple regression analysis and comparison are carrie d out.Using t and x2 tests,α=0.05,that is,P≤0.05,means statistically significant.Results:(1)Analysis of CS,HOD and total wavefront aberration(±s)before and after surgery in three groups of patients: CS: patients in group A(1.28±0.46 before surgery,1.28±0.53 after surgery),patients in group B(2.64±1.92 before surgery,1.03±0.35 after surgery),patients in group C(3.8 before surgery)1±1.23,postoperative 1.01±0.25);HOD(μm):patients in group A(preoperative 0.963±0.317,postoperative 0.892±0.346),patients in group B(preoperative 1.211±0.401,postoperative 0.310±0.281),patients in group C(1.52±0.424 before operation,0.355±0.24 after surgery);total wavefront aberration(μm):patients in group A(1.476±0.200 before operation,1.413±0.137 after surgery),patients in group B(2.589±0.540 before operation,1.054±0 after surgery).574),group C patients(3.341±0.608 before operation and 1.071±0.399 after surgery),analyzed three groups of patients,and the three indicators of CS,HOD and total wavefront aberration were reduced to varying degrees after surgery.After comparative analysis,the three groups before the operation have statistical significance in the differences in CS,HOD and total wavefront aberration(P=0.000,P=0.000);the differences in CS,HOD and total wavefront aberration in the three groups after surgery have no statistical significance(P=0.785,P= 0.274,P=0.992,P=0.366).Multivariate regression analysis results show that there is a positive correlation between the length of the pterygium invading the cornea and the preoperative CS,preoperative HOD and the total preoperative wavefront aberration(P<0.05).(2)Analysis of the BUT and tear river height(±s)of three groups of patients with preoperative,1 week after surgery and 1 month after surgery(±s): Group A patients:BUT(preoperative: 8.14±1.85,1 week after surgery: 9.05±1.84,1 month after surgery:10.06±1.55);TMH(preoperative: 0.36±0.10,1 week after surgery: 0.44±0.08,1 month after surgery 0.45±0.08);Patients in Group B: BUT(preoperative: 7.73±1.56,1 week after surgery: 8.43±1.33,1 month after surgery: 11.18±1.46);TM H(preoperative:0.34±0.07,1 week after surgery: 0.41±0.05,1 month after surgery 0.43±0.07);Patients in Group C: BUT(preoperative: 7.53±1.82,1 week after surgery: 8.68±1.04,1 month after surgery: 11.42±1.82);TMH(preoperative: 0.33±0.05,1 week after surgery:0.440±0.07,1 month after surgery 0.41±0.06),from before surgery to 1 month after surgery,the BUT and tear river height index of the three groups of patients showed an upward trend,and different pterygium invaded the cornea length,which was surgically.Both BUT and TMH have improved after treatment.The improvement in the first week after the operation is not obvious,and the BUT and TMH in the first month after the operation are significantly better than before the operation,and have reached a stable level.Compared with the three groups of preoperative and postoperative,the differences between CS,HOD and total wavefront aberration are statistically significant(P<0.001,P<0.001,P<0.001).(3)One month after the operation of the pterygium,the postoperative CS,total wavefront aberration and HOD of the three groups of patients decreased compared with the preoperative operation,and the differences were statistically significant(P<0.001).The average postoperative BUT is longer than that of preoperative,and there is a significant difference between the results of preoperative and 1 month after surgery,1week after surgery and 1 month after surgery(P<0.05),and the difference between preoperative and 1 week after surgery is not significant(P>0.05).Conclusion:The size of the pterygium and cornea invasion are related to preoperative,postoperative CS,total wavefront aberration and HOD.Moreover,pterygium excision and corneal margin stem cell transplantation can improve CS,HOD and total wavefront aberration.Group B is similar to the preoperative and postoperative improvement of Group C,but The length and area are large,the corneal damage is large,the postoperative corneal scar is wide,and the postoperative recurrence rate is high.Therefore,we believe that patients with pterygium invading the cornea length of 2.5mm～3.0mm(Group B)have better improvement of CS,HOD and total wavefront aberration after surgical treatment.Different pterygium intruded corneal lengths,and both BUT and TMH have improved after surgical treatment.The improvement in the first week after the operation is not obvious,and the BUT and TMH in the first month after the operation are significantly better than before the operation,and have reached a stable level.In terms of surgical timing,when the length of the invading cornea reaches 2.5mm-3.0mm,CS,HOD,total wavefront aberration,BUT and TMH have all been improved after surgical treatment.Therefore,we believe that the length of the invading cornea reaching 2.5-3.0mm can be used as an objective indicator of the timing of surgery. |
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