title: Corneal Polishing After Pterygium Excision With Motorized Diamond Burr: A Randomized Control Trial.
abstract: OBJECTIVE
  To evaluate outcomes of motorized diamond burr polishing versus manual polishing after pterygium excision.
  
  
  METHODS
  Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi.
  
  
  METHODS
  A randomized, interventional observer-masked controlled trial.
  
  
  METHODS
  Forty consecutive eyes underwent pterygium excision with fibrin, glue-assisted conjunctival autograft. In group 1 (20 eyes), polishing of the corneal bed was done using a crescent blade, and in group 2 (20 eyes), using a motorized diamond burr.
  
  
  RESULTS
  There was no difference in the 2 groups with respect to mean age (P=0.08), gender (P=0.3), preoperative uncorrected visual acuity (UCVA) (P=0.45), best spectacle-corrected visual acuity (BCVA) (P=0.52), spherical equivalent (P=0.5), mean astigmatism (P=0.7), tear function tests like tear break-up time, tear film meniscus height, Schirmer I and II (P=0.6, 0.5, 0.7, 0.9 respectively), pterygium dimension (P=0.4), and conjunctival autograft size (P=0.24). Mean intraoperative surgical time was significantly more in group 1 (16.9 ± 2.85 min) as compared with 12.25 ± 1.88 min in group 2 (P=0.0001). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, Schirmer I and II, and tear meniscus height at 6 months between 2 groups; however, significantly better UCVA was found in group 2 at 3 months (P=0.04). Surgically induced astigmatism (SIA) was significantly more in group 2 as compared with group 1 at 6 months (P=0.0006).
  
  
  CONCLUSIONS
  Motorized diamond burr polishing of the corneoscleral bed during primary pterygium excision in comparison with manual polishing requires significantly lesser surgical time with better UCVA, decreased astigmatism, and greater SIA at 6 months, which indicates greater astigmatic correction.
authors.affiliation: Cornea and Refractive Services (C.N.P., S.G., S.K., M.V., T.D., T.A.), Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and Department of Biostatistics (R.M.P.), All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Pinto
authors.initials: P
authors.lastname: Chikkanayakanahalli Narasimhaiah
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Khokhar
authors.forename: Murugesan
authors.initials: M
authors.lastname: Vanathi
authors.forename: Tanuj
authors.initials: T
authors.lastname: Dada
authors.forename: Ravinder M
authors.initials: RM
authors.lastname: Pandey
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology; D003228:Conjunctiva / Q000637:transplantation*; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography; D018130:Diamond; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation*; D011625:Pterygium / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D013525:Surgical Instruments; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity / Q000502:physiology
chemical_list: D018130:Diamond