Optimal Time for Stabilization of Anterior Corneal Keratometry after Primary Pterygium Excision Adjusted for Horizontal Invasion Length

초록

Purpose To determine the corneal stabilization timeline after pterygium excision adjusted for horizontal invasion length (HIL). Methods In this single-center retrospective cohort study, we analyzed 88 eyes of 80 patients with nasal or temporal primary pterygium who underwent excision and perioperative evaluation with anterior segment (AS) swept-source optical coherence tomography (SS-OCT; Anterion). Anterior simulated mean keratometry (SimKmean; 3-mm ring) and HIL were measured on AS SS-OCT. Keratometric stabilization was assessed at postoperative cutoffs of 8, 12, 16, 20, and 24 weeks using analysis of covariance (ANCOVA) with HIL as a covariate. Subgroup analysis was performed after stratifying by the median HIL (3.82 mm). Results Mean anterior SimKmean increased from 42.95 ± 1.79 diopters (D) preoperatively to 43.73 ± 1.53 D postoperatively (p < 0.001). Preoperative HIL correlated positively with the perioperative SimKmean change (r = 0.728, p < 0.001). While postoperative duration showed no significant unadjusted correlation with keratometric change (r = −0.133, p = 0.218), partial correlation controlling for HIL was negative (r = −0.248, p = 0.021), indicating diminishing change over time after severity adjustment. ANCOVA demonstrated significant stabilization at 16 weeks (p = 0.036). In the HIL ≥3.82 mm subgroup, SimKmean change was greater before 20 weeks than after 20 weeks (1.73 ± 1.59 D vs. 0.59 ± 0.74 D, p = 0.030), whereas no significant time-point differences were found for HIL <3.82 mm. Conclusions Corneal keratometric stabilization after pterygium excision depends on preoperative HIL. A minimum of 16 weeks is recommended before cataract surgery planning, with at least 20 weeks for eyes with HIL ≥3.82 mm.

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