THE EFFECT OF PTERYGIUM SURGERY WITH CONJUNCTIVAL AUTOGRAFT ON LIMBAL MICROANATOMY

It was aimed to investigate the effect of pterygium surgery with conjunctival autograft on the microanatomy of the limbal region using anterior segment OCT and in-vivo corneal confocal microscopy (IVCM). 

poster presentation

Limbal epithelial thickness, central corneal thickness (CCT) and corneal and conjunctival epithelial thicknesses were measured with OCT cross-sectional images taken from the nasal and superior corneal limbal region of patients who had undergone pterygium surgery with autograft (C), who were diagnosed with pterygium (P) and healthy control (K). (average of 3 measurements), the location, density and stromal changes of Vogt palisades were examined in the images taken from the nasal and superior limbus of the patients who had undergone surgery with IVCM and the controls. 

Considering the demographic characteristics of the participants, age: Group P = 52.45±12.00; Group C=48.97±10.44 and Group K=49.43±9.17 years, there was no difference (F=1.089; p=0.340). The Woman/Man ratio of the patients was 61/54. Measured by OCT between all 3 groups; K= 527, 53±40.84 p=0.5), nasal (P=106.69±28.27; C=99.95±29.33; K= 94.36±13.29 p=0.266), superior corneal limbal (P=115, 36±20.90; C=109.20±18.66; K=111, 66±18.27 p=0.42) thickness and CCT (P=520, 46±33.07 ; C=518; 82±42.90 were similar. When the findings within the group were compared with the other eyes, there was no statistically significant difference in terms of the same values. In all 3 groups, the corneal nasal limbal epithelial thickness was higher than the upper one and was not statistically significant (pP = 0.442; pC=0.964; pK=0.509).In the surgical eyes, a decrease in the alternating epithelial stromal extensions formed by the vogt striae at the basal epithelial level, and increased hyperreflectivity in the more superficial layers, and disorganized hyperreflective bands at the substantia propria level were detected. 

The lack of a difference in limbal epithelial cell thickness, where the Vogt palisade is located, may also be due to insufficient OCT resolution. Defects in the density and order of the palisade structure in the autograft area provide information about micro-level structural changes after surgery.