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Cosmetic outcome of femtosecond laser-assisted pterygium surgery

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 pterygi...

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Autores principales: Ting, Darren Shu Jeng, Liu, Yu-Chi, Lee, Yi Fang, Ji, Angel Jung Se, Tan, Tien-En, Htoon, Hla M., Mehta, Jodhbir S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936441/
https://www.ncbi.nlm.nih.gov/pubmed/33673873
http://dx.doi.org/10.1186/s40662-021-00230-w
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author Ting, Darren Shu Jeng
Liu, Yu-Chi
Lee, Yi Fang
Ji, Angel Jung Se
Tan, Tien-En
Htoon, Hla M.
Mehta, Jodhbir S.
author_facet Ting, Darren Shu Jeng
Liu, Yu-Chi
Lee, Yi Fang
Ji, Angel Jung Se
Tan, Tien-En
Htoon, Hla M.
Mehta, Jodhbir S.
author_sort Ting, Darren Shu Jeng
collection PubMed
description 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 ± 9.8 μm) was fashioned intraoperatively. An excellent cosmetic outcome of FLAPS (median ± IQR) was observed at 3 months (1.0 ± 1.0) and remained similar at 6 months (1.0 ± 0.0) and 12 months (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. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02866968. Registered in July 2016, SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40662-021-00230-w.
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spelling pubmed-79364412021-03-08 Cosmetic outcome of femtosecond laser-assisted pterygium surgery Ting, Darren Shu Jeng Liu, Yu-Chi Lee, Yi Fang Ji, Angel Jung Se Tan, Tien-En Htoon, Hla M. Mehta, Jodhbir S. Eye Vis (Lond) Research 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 ± 9.8 μm) was fashioned intraoperatively. An excellent cosmetic outcome of FLAPS (median ± IQR) was observed at 3 months (1.0 ± 1.0) and remained similar at 6 months (1.0 ± 0.0) and 12 months (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. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02866968. Registered in July 2016, SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40662-021-00230-w. BioMed Central 2021-03-06 /pmc/articles/PMC7936441/ /pubmed/33673873 http://dx.doi.org/10.1186/s40662-021-00230-w Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ting, Darren Shu Jeng
Liu, Yu-Chi
Lee, Yi Fang
Ji, Angel Jung Se
Tan, Tien-En
Htoon, Hla M.
Mehta, Jodhbir S.
Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title_full Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title_fullStr Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title_full_unstemmed Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title_short Cosmetic outcome of femtosecond laser-assisted pterygium surgery
title_sort cosmetic outcome of femtosecond laser-assisted pterygium surgery
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936441/
https://www.ncbi.nlm.nih.gov/pubmed/33673873
http://dx.doi.org/10.1186/s40662-021-00230-w
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