Monitoring corneal densities following primary pterygium excision with adjuvant topical mitomycin-C application--an observational study of corneal scar changes.

Purpose: Corneal densitometry is an inherent feature of the Pentacam device. We aim to assess the changes in corneal scar density with serial Scheimpflug images following primary pterygium excision with topical application of mitomycin-C.
Methods: We recruited patients who underwent primary, single-headed pterygium excision with topical adjuvant mitomycin-C. Scheimpflug images were taken at postoperative weeks 1, 4, and 12, and all patients received topical corticosteroid and antibiotic treatment for at least 4 weeks postoperatively. Corneal scar densities were generated by the software for analysis. Secondary outcome measures included intraocular pressures and pterygium recurrence at the end of 12 weeks. Changes in corneal densities between weeks 12, 4, and 1 were calculated.
Results: We recruited 31 eyes of 31 patients, of whom 16 were male patients and 15 were female patients, with 19 left and 12 right eyes. Mean age at operation was 62.0 ± 9.4 years. Mean reduction in density of the anterior 120 μm of cornea was -3.07 [95% confidence interval (CI), -6.600 to 0.460] and -3.455 (95% CI, -6.787 to -0.122) at postoperative 4 and 12 weeks, respectively, and mean reduction percentage was -4.7% (95% CI, -10.7% to 1.3%) and -6.3% (95% CI, -11.8% to -0.7%), respectively. No steroid response or pterygium recurrence was reported.
Conclusions: Corneal densitometry is an objective measure to detect scar changes in zones and layers. The overall reduction of density was evident at 12 weeks postoperatively. These results might serve as baseline figures for future studies in assessing modulation of corneal scars over time.