Cosmetic outcome of femtosecond laserassisted pterygium surgery  

作　　者：Darren Shu Jeng Ting Yu-Chi Liu Yi Fang Lee Angel Jung Se Ji Tien-En Tan Hla M.Htoon Jodhbir S.Mehta 

机构地区：[1]Academic Ophthalmology,Division of Clinical Neuroscience,School of Medicine,University of Nottingham,Nottingham,UK [2]Department of Ophthalmology,Queen’s Medical Centre,Nottingham,UK [3]Singapore Eye Research Institute,Singapore,Singapore [4]Singapore National Eye Centre,11 Third Hospital Avenue,Singapore 168751,Singapore [5]Duke-NUS Graduate Medical School,Singapore,Singapore.

出　　处：《Eye and Vision》2021年第1期59-66,共8页眼视光学杂志（英文）

摘　　要：Background:To examine the cosmetic outcome of femtosecond laser-assisted pterygium surgery(FLAPS)with conjunctival autograft(CAG)and its potential predictive factors.Methods:This was a prospective interventional case series(NCT02866968).We included 29 patients(29 eyes)with primary pterygium who underwent FLAPS.Cosmetic outcome was graded by two graders(an ophthalmology resident and an experienced ophthalmologist)using Hirst classification system(1-4=excellent-poor).Weighted Cohen’s kappa analysis was performed to examine the intra-and inter-rater reliability.The relationship between cosmetic outcome and various factors were determined by Spearman’s correlation coefficients(r).Results:The preoperative severity of pterygium(Tan grading system)was mild/atrophic(7%),moderate/intermediate(62%),and severe/fleshy(31%).An ultrathin CAG(mean thickness of 74.5±9.8μm)was fashioned intraoperatively.An excellent cosmetic outcome of FLAPS(median±IQR)was observed at 3 months(1.0±1.0)and remained similar at 6months(1.0±0.0)and 12months(1.0±0.0)postoperatively.At final follow-up,27(93%)patients achieved good-to-excellent cosmetic outcome,with 1(3%)patient having a poor outcome due to incomplete pterygium removal.Weighted kappa analysis of Hirst grading system showed excellent intra-rater(κ=0.86-0.95)and inter-rater reliability(κ=0.84-0.88).There was a weak and borderline significant correlation between good cosmetic outcome and reduced postoperative CAG thickness(r=0.38,P=0.06)but not with age,gender,preoperative pterygium severity,or intraoperative CAG thickness.Conclusions:FLAPS can result in an excellent cosmetic outcome,which may be attributed to the beneficial effect of an ultrathin CAG.

关 键 词：COSMESIS Cosmetic outcome Femtosecond laser PTERYGIUM Pterygium surgery 

分 类 号：R779.6[医药卫生—眼科]