EFFECT OF PTERYGIUM SURGERY ON PRECORNEAL TEAR FILM

Abstract

Pterygium is a common disease of the ocular surface characterized by the invasion of fibrovascular tissue from the bulbar conjunctiva onto the cornea. It can cause chronic ocular irritation, tear film disturbances, induced astigmatism, and decreased vision secondary to growth over the visual axis.1 • The first line of defence against environmental injury, including ultraviolet exposure is the precorneal tear film. Many authors suggest that disturbed tear film function in pterygium occurs because of pathological conjunctival, corneal, or eyelid changes while others suggest that abnormal tear function is a risk factor for dry eye.2 • Therefore we are investigating the tear film changes before and after pterygium surgery in tertiary care centre kolar .There are lot of patients coming with complaints of burning sensation, foreign body sensation with pterygium of different grades. • The presence of pterygium and dry eye symptoms often co-exist. Pterygium disturbs the tear film. The extent to which the excision of pterygium will affect the tear film needs to be evaluated.2 Methods This prospective observational study was done on all consecutive patients with pterygium came to ophthalmology OPD at R L Jalappa hospital in kolar from August 2022 to December 2023. A total of 39 eyes were included in each group of which 12 were males and 27 females. All the patients subjected for detail visual acuity (VA) assessment, slit lamp examination, intraocular pressure (IOP) estimation, tear film function tests and underwent Pterygium excision with conjunctival limbal autograft. They were followed post- operatively 1 week, 4 weeks and 6weeks. xv Results: Majority of the patients were females (69.2%), while 30.8% were males with average age (in years) as 51.33 years. Majority had Type 2 (51.3%), followed by Type 3 (26.6%) and Type 1 (23.1%). Schimers test 1 was significantly decreased in the affected eye compared to control eye at pre-op and 1 week following post-op. There was no significant difference in the ST1 at 4 weeks and 6 weeks between the affected and control eyes. Schimers test 2 was significantly decreased in the affected eye compared to control eye at pre-op, one week and four weeks following post-op. There was no significant difference in the ST-2 at 6 weeks between the affected and control eyes. TBUT was significantly decreased in the affected eye compared to control eye at pre-op, and 4 weeks following post-op. There was no significant difference in the TBUT at 1 week and 6 weeks between the affected and control eyes TMH was significantly lower in the affected eye than the control eye at pre-op, and 1 week following post-op. No significant difference in the TMH at 4 weeks and 6 weeks between the affected and control eyes was noticed Comparision of schirmers test 1, schirmers 2, TBUT and TMH at 1week,4week & 6 weeks between preop and post op in type 1 pterygium, among the affected eye, the tear film function significantly improved.