The effect of pterygium surgery on wavefront analysis


1 Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Pterygium is a common disorder of the ocular surface. It causes vision impairment -usually irregular type astigmatism- through different mechanisms. In addition, it is believed that surgical excision of the pterygium improves visual problems. The appropriate method to investigate irregular astigmatism is using wavefront analysis. This study was aimed to evaluate wavefront analysis pre and post pterygium surgery.
Materials and Methods: This study was performed on 32 patients who underwent surgical excision of pterygium in January 2012. Data were recorded and compared after pre and postoperative comprehensive ophthalmologic examinations including uncorrected and best corrected visual acuity, Orbscan, wavefront analysis and autorefraction to figure out the effects of surgery on different parameters.
Results: Comparison of pre and postoperative parameters showed that surgical treatment of the pterygium improves numerous parameters significantly including uncorrected and best corrected visual acuity, spherical and cylinder refractive error, higher order aberration, quadrafoil (Z440), corneal astigmatism and 3 and 5 mm central zone corneal irregularity (all P-values < 0.0001). In addition, it improves vertical coma (P:0.003) and secondary astigmatism (Z420) (P:0.004).
Conclusion: It is concluded that surgical excision of the pterygium improves visual acuity, refractive errors and most of the corneal topographic indices and wavefront analysis parameters.


1. Coroneo MT, Di Girolamo N, Wakefield D. The pathogenesis of pterygia. Curr Opin Ophthalmol 1999;10:282-8.  Back to cited text no. 1
2. Saleem MI, Channar MS, Saleem MF. Effects of pterygium excision on corneal curvatures. Pak J Med Sci 2011;27:325-8.  Back to cited text no. 2
3. Zare M, Zarei-Ghanavati S, Ansari-Astaneh MR, Baradaran-Rafiee A, Einolahi B. Effects of pterygium on ocular aberrations. Cornea 2010;29:1232-5.  Back to cited text no. 3
4. Kheirkhah A, Casas V, Sheha H, Raju VK, Tseng SC. Role of conjunctival inflammation in surgical outcome after amniotic membrane transplantation with or without fibrin glue for pterygium. Cornea 2008;27:56-63.  Back to cited text no. 4
5. Bedrossian RH. The effects of pterygium surgery on refraction and corneal curvature. Arch Ophthalmol 1960;64:553-7.  Back to cited text no. 5
6. Uy HS, Reyes JM, Flores JD, Lim-Bon-Siong R. Comparison of fibrin glue and sutures for attaching conjunctival autografts after pterygium excision. Ophthalmology 2005;112:667-71.  Back to cited text no. 6
7. Starck T, Kenyon KR, Serrano F. Conjunctival autograft for primary and recurrent pterygia: Surgical technique and problem management. Cornea 1991;10:196-202.  Back to cited text no. 7
8. Gumus K, Erkilic K, Topaktas D, Colin J. Effect of pterygia on refractive indices, corneal topography, and ocular aberrations. Cornea 2011;30:24-9.  Back to cited text no. 8
9. Fong KS, Balakrishnan V, Chee SP, Tan DT. Refractive change following pterygium surgery. CLAO J 1998;24:115-7.  Back to cited text no. 9
10. Lin A, Stern G. Correlation between pterygium size and induced corneal astigmatism. Cornea 1998;17:28-30.  Back to cited text no. 10
11. Tomidokoro A, Miyata K, Sakaguchi Y, Samejima T, Tokunaga T, Oshika T. Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology 2000;107:1568-71.  Back to cited text no. 11
12. Tomidokoro A, Oshika T, Amano S, Eguchi K, Eguchi S. Quantitative analysis of regular and irregular astigmatism induced by pterygium. Cornea 1999;18:412-5.  Back to cited text no. 12
13. Maloney RK, Bogan SJ, Waring GO 3 rd . Determination of corneal image-forming properties from corneal topography. Am J Ophthalmol 1993;115:31-41.  Back to cited text no. 13
14. Visser N, Berendschot TT, Verbakel F, Tan AN, de Brabander J, Nuijts RM. Evaluation of the comparability and repeatability of four wavefront aberrometers. Invest Ophthalmol Vis Sci 2011;52:1302-11.  Back to cited text no. 14
15. Schallhorn SC, Farjo AA, Huang D, Boxer Wachler BS, Trattler WB, Tanzer DJ, et al. Wavefront-guided LASIK for the correction of primary myopia and astigmatism a report by the American Academy of Ophthalmology. Ophthalmology 2008;115:1249-61.  Back to cited text no. 15
16. Kohnen T, Klaproth OK, Bühren J. Effect of intraocular lens asphericity on quality of vision after cataract removal: An intraindividual comparison. Ophthalmology 2009;116:1697-706.  Back to cited text no. 16
17. Katsoulos C, Karageorgiadis L, Vasileiou N, Mousafeiropoulos T, Asimellis G. Customized hydrogel contact lenses for keratoconus incorporating correction for vertical coma aberration. Ophthalmic Physiol Opt 2009;29:321-9.  Back to cited text no. 17
18. Pesudovs K, Figueiredo FC. Corneal first surface wavefront aberrations before and after pterygium surgery. J Refract Surg 2006;22:921-5.  Back to cited text no. 18
19. Bahar I, Loya N, Weinberger D, Avisar R. Effect of pterygium surgery on corneal topography: A prospective study. Cornea 2004;23:113-7.  Back to cited text no. 19
20. Maheshwari S. Pterygium Induced Refractive Changes. Indian J Ophthalmol 2007;55:383-6.  Back to cited text no. 20
[PUBMED]  Medknow Journal  
21. Yilmaz S, Yuksel T, Maden A. Corneal topographic changes after four types of pterygium surgery. J Refract Surg 2008;24:160-5.  Back to cited text no. 21
22. Oh JY, Wee WR. The effect of pterygium surgery on contrast sensitivity and corneal topographic changes. Clin Ophthalmol 2010;4:315-9.  Back to cited text no. 22
23. Cinal A, Yasar T, Demirok A, Topuz H. The effect of pterygium surgery on corneal topography. Ophthalmic Surg Lasers 2001;32:35-40.  Back to cited text no. 23
24. Stern GA, Lin A. Effect of pterygium excision on induced corneal topographic abnormalities. Cornea 1998;17:23-7.  Back to cited text no. 24
25. Yagmur M, Ozcan AA, Sari S, Ersöz TR. Visual acuity and corneal topographic changes related with pterygium surgery. J Refract Surg 2005;21:166-70.  Back to cited text no. 25
26. Maheshwari S. Effect of pterygium excision on pterygium induced astigmatism. Indian J Ophthalmol 2003;51:187-8.  Back to cited text no. 26
[PUBMED]  Medknow Journal  
27. Yousuf M. Role of pterygium excision in pterygium induced astigmatism. JK-Practitioner 2005;12:91-2.  Back to cited text no. 27
28. Yasar T, Ozdemir M, Cinal A, Demirok A, Ilhan B, Durmus AC. Effects of fibrovascular traction and pooling of tears on corneal topographic changes induced by pterygium. Eye (Lond) 2003;17:492-6.  Back to cited text no. 28
29. Oldenburg JB, Garbus J, McDonnell JM, McDonnell PJ. Conjunctival pterygia. Mechanism of corneal topographic changes. Cornea 1990;9:200-4.  Back to cited text no. 29
30. Budak K, Khater TT, Friedman NJ, Koch DD. Corneal topographic changes induced by excision of perilimbal lesions. Ophthalmic Surg Lasers 1999;30:458-64.  Back to cited text no. 30