Evaluation of Refractive Status Changes Following Pterygium Surgery With the Bare Sclera Technique Versus Conjunctival Autografting in a Tertiary Eye Care Centre in Kolkata: A Prospective Comparative Study

Background Therapeutic options for pterygium are primarily surgical. Several techniques are available for the surgical excision of pterygium. This study aims to compare the refractive status change following pterygium surgery between the bare sclera and the limbal conjunctival autograft technique. Methods The study subjects included 110 patients (110 eyes) with primary nasal pterygium who underwent surgery. After a full preoperative assessment, all patients were randomly allocated to either group A (bare sclera technique, BST) or group B (limbal conjunctival autograft technique, LCAT). All patients were assessed for visual acuity in LogMAR score, refraction in diopters (D), and keratometry values in diopters (D) at the first OPD visit and postoperatively after two weeks, four weeks, and 12 weeks. Quantitative data were expressed as means and standard deviations, while qualitative data were expressed in frequencies and percentages. To compare the variables, paired and unpaired t-tests were used. A p< 0.05 was considered statistically significant. Result The preoperative mean visual acuity was improved from LogMAR score 0.37±0.15 to LogMAR score 0.15±0.10 with a p-value <0.001 and from LogMAR score 0.37±0.17 to LogMAR score 0.08±0.09 with a p-value <0.001 after 12 weeks of surgery in the BST and the LCAT, respectively. The preoperative mean astigmatism was reduced from 2.10±0.84 D to 1.30±0.56 D (p <0.001) and from 2.08±0.96 D to 0.70±0.40 D (p <0.001) after 12 weeks of surgery in the BST and LCAT, respectively. The improvement in mean visual acuity was better in the LCAT than in the BST, and the difference between the groups was statistically significant (p <0.001) after 12 weeks of surgery. The reduction in post-operative mean astigmatism was greater in the LCAT than in the BST, and the difference between the groups was statistically significant (p < 0.001) after 12 weeks of surgery. The difference in keratometry values after 12 weeks of surgery between the two groups was also found to be statistically significant (p < 0.05). Conclusion Pterygium excision resulted in better improvement in the limbal conjunctival autograft technique than the bare sclera technique in terms of visual acuity, astigmatism, and keratometry values.