Changes of Corneal Astigmatism Before and After Pterygium Excision

Background:Pterygium can induce significant astigmatic changes, affecting visual acuity. Surgical excision is often recommended, yet its precise impact on astigmatism using modern diagnostic tools remains underexplored. Aim:This study aimed to precisely evaluate the effect of pterygium excision on astigmatic changes using an auto refractometer and Pentacam. Patients and Methods: This interventional, single-arm study was conducted at the ophthalmology outpatient clinics of Benha University Hospitals. A random sample of 25 patients aged 29–70 years with primary pterygium was included. Exclusion criteria were ocular surface disease, prior eye surgery, use of topical anti-glaucoma drops, non-cooperation, or mental conditions interfering with data interpretation. Each patient underwent a complete ocular examination including visual acuity, fundus examination, and astigmatism assessment via auto refractometer and Pentacam. All surgeries were performed by a single surgeon with follow-up at three months postoperatively. Results:The median preoperative mean astigmatism decreased significantly from 2.4 D to 0.7 D postoperatively. Median spherical refraction decreased non-significantly from +0.88 D to +0.63 D, while cylindrical refraction declined significantly from -2 D to -0.75 D. Flat keratometry (FK1) increased significantly from 42.45 D to 43.95 D; steep keratometry (FK2) showed a slight non-significant decrease from 45.01 D to 44.99 D. Median uncorrected visual acuity improved from 0.3 to 0.7, and best-corrected visual acuity from 0.6 to 0.8. Conclusion: Pterygium excision significantly improves visual acuity and reduces astigmatism, highlighting the importance of surgical intervention in affected patients.