[Excimer laser versus diamond fraise: equal short-term outcome of corneal smoothing in pterygium operations].

Background: The treatment of pterygia often results in irregular astigmatism. Corneal smoothing at the end of surgery plays a major role in the development of astigmatism. The aim of our study was to compare the efficiency of corneal smoothing performed by phototherapeutic keratectomy compared with the conventional method performed by a diamond fraise. The effect of postoperative excimer laser smoothing on refraction, visual acuity and irregular astigmatism was investigated.
Patients and Methods: 32 eyes underwent pterygium excision using a standardized surgical procedure. In addition 9 eyes underwent postoperative phototherapeutic keratectomy of the wound region with an excimer laser, 23 eyes were treated with a diamond fraise for corneal smoothing. The postoperative examination was performed 7, 14 and 30 days after surgery. Corneal topography was performed by a computer-assisted videokeratoscope (TMS-1). The results were evaluated by the Fourier transform analysis.
Results: Both methods showed similar results concerning refraction and visual acuity postoperatively. Preoperatively all patients had an irregular flattening of the corneal topography in the area of the pterygium. Postoperatively a small irregular flattening was left in eyes treated with a diamond fraise. In the excimer laser treated group a steepening in the corneal topography could be observed.
Conclusions: The phototherapeutic keratectomy with excimer laser in the treatment of pterygia suggests to be a gentle alternative creating a smooth wound surface. Despite of this advantage the treatment with the excimer laser effects a remarkable increase in administration and expense.