The Effect Of Pterygium Surgery On Limbal Microanatomy

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

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Ophthalmology, Ankara, Türkiye

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). Location and density of vogt palisades, stromal changes and epithelial basal cell numbers in the crypts were examined in the images taken from the nasal and superior limbus of the same groups with IVCM.

Considering the demographic characteristics of the participants, age: group P = 52.45±12.00; C=48.97±10.44 and K=49.43±9.17 years ( p=0.340). Measured by OCT among all 3 groups; nasal (P=106.69±28.27; C=99.95±29.33; K= 94.36±13.29 p=0.266), superior 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; K= 527.53±40.84 p=0.5) were similar. 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). Confocal epithelial basal cell counts at limbal palizades of those in groups P and K are significantly higher than those in group C (P=3021.91±631.15, K= 3937.87±321.85, C= 2401.47±502.20; p<0.001 ). 

Pterygium surgery has effects on limbal microanatomy. IVCM revealed, limbal palisades’ epithelial basal cell density was significantly lower in pterygium surgery group, which may indicate a pre-clinic state of limbal stem cell deficiency exists.