目的：研究翼状胬肉的长度、宽度及胬肉覆盖角膜的面积对角膜表面形态的影响以及术后的改善情况。方法：对翼状胬肉病人（33人，45只眼）术前进行剪影验光及角膜地形图检查，术中测量翼状胬肉的宽度及长度，对翼状胬肉的宽度、长度及面积与角膜表面的规则系数、不规则系数及角膜散光进行相关性研究；对随访病人（23人，28只眼）进行术后的角膜地形图检查，观察各项指标的变化，从而找出最好的手术时机。结果：术前翼状胬肉的长度与角膜散光(r = 0.304, P=0.042), SRI (r = 0.478, P=001)和 SAI (r = 0.507, P < 0.001)具有明显的相关性；翼状胬肉的宽度及面积与SRI (r=0.490, P=0.001; r=0.599, P< 0.001)和SAI (r=0.508,P<0.001;r=0.583,P<0.001)有明显的相关性；而散光却与SRI及SAI (r=0.253, P=0.093; r=0.268, P=0.075)无明显的相关性。术后只有角膜散光的改善具有显著性差异（P=0.023），而SRI及SAI的改善无显著性差异(P=0.423；P=0.143)。结论：翼状胬肉的出现、生长及其手术切除对角膜的球面性、规则性以及散光均有影响，而有些影响是不能通过手术解除，所以本研究建议可适当的提前手术时机。

关键词：翼状胬肉，散光，角膜规则指数，角膜表面不对称指数，角膜地形图。

Study of correlation between

ptyerytium size and corneal topography

ABSTRACT:OBJECTIVE: To evaluate prospectively the corneal refractive status before and after pterygium surgery and its relationship with preoperative pterygium size. METHODS: forty-five eyes undergoing pterygium removal surgery were measured astigmatism, surface regularity index (SRI), and surface asymmetry index (SAI) before and after surgery (twenty-eight eyes followed up), and the preoperative pterygium size (including long, width and area). RESULTS: Before surgery, pterygium long significantly correlated with astigmatism (r = 0.304, P=0.042), SRI (r = 0.478, P=001), and SAI (r = 0.507, P < 0.001). pterygium width and area significantly correlated with SRI (r=0.490, P=0.001; r=0.599, P< 0.001),SAI (r=0.508, P<0.001; r=0.583,P<0.001),except astigmatism (r=0.253, P=0.093; r=0.268, P=0.075). The surgery significantly decreased astigmatism (P=0.023), whereas SRI, and SAI were not changed significantly (P=0.423; P=0.143). CONCLUSIONS: The presence of pterygium and its removal significantly influence the corneal refraction including spherical power, astigmatism, asymmetry, and irregularity, with the larger pterygium exerting the greater influence. This finding helps to identify those patients who may benefit from surgical intervention.

Key words: pterygium, astigmatism, SRI, SAI, corneal topography.
LI Na, ZOU Liuhe，SU Xiaoduo，PAN Zhiqiang. Capital University of Medical Sciences, Beijing TongRen Ophthalmic Center. Beijing 100730, China.

Corresponding author: Li Na (Email: wmzi64@Yahoo. com)