EC Ophthalmology

Case Series Volume 14 Issue 6 - 2023

A Case Series on Patients Having Preoperative Non-with-the-Rule Corneal Astigmatism and Showing Failure of Visual Improvement After Pterygium Excision

Fathy Fawzy Morkos1, Maged Maher Roshdy1,2, Mona Fathy1, Tamer Abdelfattah Badran2 and Rania Serag Elkitkat1,2,3*

1Watany Eye Hospital, Cairo, Egypt
2Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
3Ophthalmology Department, Faculty of Medicine, MTI University, Cairo, Egypt

*Corresponding Author: Rania Serag Elkitkat, Watany Eye Hospital and Ophthalmology Department, Faculty of Medicine, Ain Shams University and Ophthalmology Department, Faculty of Medicine, MTI University, Cairo, Egypt.
Received: May 17, 2023; Published: May 31, 2023




Purpose: To report on failure of visual improvement following pterygium excision in a cohort having preoperative non-with-the-rule (non-WTR) corneal astigmatism.

Patients and Methods: This is a retrospective case series study that was conducted at Watany Eye Hospital, Cairo, Egypt, on patients having preoperative non-WTR corneal astigmatism. Visual and refractive changes after surgery were reported. Relevant data were retrieved from the captured pre-and postoperative Pentacam HR imaging, including changes in topographic corneal astigmatism and pterygium encroachment on the visual axis.

Results: The percentage of non-WTR cases during a period of 29 months was 9.45% (7 out of 74 cases). The preoperative Pentacam flat meridian deviation from the horizontal (1800) axis had a median of 600. The median pterygium extent was 210 mm before the visual axis. The seven patients had statistically insignificant differences in Corrected Distance Visual Acuity “CDVA”, Pentacam corneal astigmatism, and mean keratometry “Km” between the pre-and postoperative values (six months after pterygium excision) (P-value = 0.125, 0.578, and 0.813 respectively).

Conclusion: Pterygia usually induce flattening of the horizontal corneal meridian causing WTR astigmatism. The sparse entity of patients having preoperative non-WRT corneal astigmatism has a less favorable visual prognosis following pterygium excision. Ophthalmologists should discuss with such patients the unfavorable visual and refractive outcomes and would rather defer from performing surgeries in such an entity of patients.

Keywords: Pterygium; Pterygium Excision; Non-with-the-Rule Astigmatism; Corneal Astigmatism; Outcome of Pterygium Surgery

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Fathy Fawzy Morkos., et al. A Case Series on Patients Having Preoperative Non-with-the-Rule Corneal Astigmatism and Showing Failure of Visual Improvement After Pterygium Excision. EC Ophthalmology 14.6 (2023): 06-10.

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