Effect of Primary Pterygium on Endothelial Cell Density

Abstract

Pterygium is a proliferation of fibrovascular tissue over the cornea, causing inflammation and neovascularization. Risk factors include genetic predisposition and chronic environmental irritation. Four grades exist, affecting the corneal limbus, pupil, and pupillary area. Pterygium formation causes flattening of the horizontal meridian and changes in corneal layers to determine if there is a correlation between primary Pterygium and a decrease in corneal endothelial cell density (ECD). This cross-sectional random observational comparative study analyzed 50 patients at Benghazi Teaching Eye Hospital from December 2023 to February 2024. Patients with unilateral pterygium were included. The study assessed endothelial cell count using non-contact specular microscopy and analyzed the corneal endothelial parameters using a Topcon Specular Microscope. The study participants were 74% male, with a mean age of 53.74 +11.06 years. Pterygium grading revealed that 36% had grade one, 62% had grade two, and only 2% had grade three. The study found a significant difference in endothelial cell density between the case and control groups(p<0.001), with the case group having a lower mean ECD than the control group. Central corneal thickness was also significantly different between eyes with primary pterygium invasion and those without(p<0.001). However, the Kruskal-Wallis Test showed no significant association between pterygium grading and endothelial cell density(p>0.05). Primary pterygium significantly affects corneal endothelial cell density and central corneal thickness. Further research is needed to understand its clinical implications and correlation with pterygium progression. Understanding pterygium's impact on corneal health and the regularity of astigmatism could improve management and treatment options.