To investigate the characteristics of ocular surface inflammation index after pterygium excision by using Oculus Keratograph^® 5M and Visual analogue scale and evaluated the effectiveness of anti-inflammatory treatment.

A prospective case control study was performed.Eighteen patients (6 males and 12 females) who suffered from primary pterygium were recruited in Zhongshan Ophthalmic Center from June to September 2016.All patients were treated with monocular pterygium excision combined with amniotic membrane transplantation.Anti-inflammatory treatment was given after surgery, and the ocular inflammation index was evaluated at preoperative and 1st, 3rd, 7th, 10th, 30th and 60th day postoperative.The temporal conjunctival hyperemia index (TCHI) was assessed by Oculus Keratograph^® 5M with a red eye index analysis software.Ocular symptom scores (OSS) and visual analogue scale (VAS) were used to analyze the subjective symptoms of the patients.Fluorescein staining was used to detect the epithelization of corneal and scleral wound.The best corrected visual acuity (BCVA), intraocular pressure and complications were evaluated in this study.This study was approved by the Medical Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (2016KYPJ024). All patients signed informed consent for clinical research.

No drug-related ocular and systemic adverse events were found during the follow-up.Corneal epithelial defect was recovered on 10th day, and conjunctival epithelization was observed in sclera exposed area on 30th day.The BCVA on the 60th day was 0.12±0.17, which was significantly lower than 0.34±0.36 preoperatively (t=3.401, P=0.003). Compared with those before surgery, OSS and VAS were significantly increased on 1st day (OSS: Z=-4.255, P=0.000; VAS: Z=-5.256, P=0.000). The OSS on 7th day was not significantly different from that before surgery (Z=-0.958, P=0.372). VAS decreased to baseline on 30th day.The OSS on 60th day after surgery was significantly lower than that before surgery (Z=-2.397, P=0.037). TCHI was higher than 1.2 preoperatively, and increased to the highest on 1st day after surgery, with significant difference between them (t=-6.620, P=0.000). The TCHI decreased to baseline on 7th day, no significant difference were obtained when compared with preoperative TCHI (t=-1.050, P=0.310), and TCHI on 60th day after surgery was lower than that before surgery, with significant difference between them (t=2.758, P=0.020).

The subjective symptoms combined with conjunctival hyperemia can be more accurate assessment of ocular surface inflammation in the perioperative period of pterygium surgery, which can be used as an evaluation index to assess the effectiveness of anti-inflammatory treatment.

Pterygium; Ocular inflammation; Hyperaemia index; Symptom score; Visual analogue scale