Association between fibrovascular translucency of pterygium and corneal curvature and aberrations after adjustment for horizontal invasion length

초록

This study aims to determine whether the translucency-based clinical grade of pterygium shows independent relationships with anterior and posterior corneal curvature and anterior wavefront aberrations, with adjustment for horizontal invasion length (HIL) measured by anterior segment swept-source OCT (AS-SS-OCT). This study involved 53 eyes from 51 patients diagnosed with primary nasal pterygium. The clinical grade of the pterygium was evaluated using T grade based on the fibrovascular translucency. AS SS-OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) provided HIL (mm), thickness (µm), anterior/posterior keratometry at the 3.0-mm ring, and anterior corneal wavefront metrics within a 6.0-mm zone. The device was also used to evaluate the magnitudes for the individual 1st - to 4th-order aberrations of the anterior corneal fields. Also, the 4th-7th order root mean square (RMS), RMS low-order aberration (LoA), and RMS high-order aberration (HoA) values were collected. For statistical analysis, Spearman's rank correlation test and Pearson's correlation test were performed, along with partial correlation test adjusted for HIL. The mean age of subjects was 59.3±11.4 years, and 51.0% were female. T grade correlated positively with HIL. HIL showed strong associations with anterior Sim K average, anterior Sim K steep, anterior Sim K flat, and anterior corneal astigmatism-but not with posterior corneal parameters. HIL also showed significant correlations with multiple anterior corneal wavefront parameters. After adjustment for HIL, T grade remained independently correlated with anterior Sim K flat, RMS LoA, and defocus; no significant relationships were observed with other Zernike terms or posterior metrics. Additionally, T grade was positively correlated with pterygium thickness. T grade adds independent, complementary information (associations with flat K, LoA RMS, and defocus) even after controlling for HIL. Incorporating T grade into preoperative assessment may improve estimation of optical burden and surgical prognosis.

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