{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T19:01:30Z","timestamp":1775847690893,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aims<\/jats:title>\n<jats:p>This study aimed to report corneal steep island (CSI) formation following primary pterygium surgery and to identify preoperative pterygium morphological features that predict the likelihood of CSI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 93 eyes from 84 subjects with primary nasal pterygium, who underwent pterygium excision combined with conjunctival-limbal autograft, were included in this retrospective longitudinal cohort study. CSI was defined using anterior segment swept-source optical coherence tomography (AS SS-OCT). Eyes were divided into two groups: those with postoperative CSI formation (Group 1) and those without postoperative CSI (Group 2). We compared postoperative anterior corneal astigmatism (ACA, in diopters [D]) and root mean square (RMS) values of anterior corneal lower-order (LoA) and higher-order aberrations (HoA) between the groups. Baseline clinical severity grades of pterygium based on the pre-established pterygium body morphology and vascularity, ACA, and AS SS-OCT-guided pterygium morphological profiles (horizontal invasion length [HIL, mm], height [\u03bcm], thickness (\u03bcm), and residual corneal thickness [RCT]\/central corneal thickness [CCT] ratio [RCT\/CCT]) were also compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Postoperative CSI occurred in 26 eyes (28.0%) with a maximum follow-up duration of 22.9\u00b127.4 months. Group 1 exhibited significantly higher postoperative anterior corneal RMS LoA and HoA, as well as the RMS values of the 4<jats:sup>th<\/jats:sup> to 6<jats:sup>th<\/jats:sup> orders. Although clinical severity grades of pterygium did not differ between groups, baseline ACA was higher in Group 1 (4.56\u00b15.49 D vs. 2.70\u00b13.80 D, <jats:italic>P<\/jats:italic> = 0.009). HIL (4.49\u00b10.84 mm vs. 3.77\u00b11.29 mm, <jats:italic>P<\/jats:italic> = 0.010) was higher in Group 1, while pterygium height (930.8\u00b184.4 \u03bcm vs. 999.3\u00b1128.0 \u03bcm, <jats:italic>P<\/jats:italic> = 0.015) and RCT\/CCT ratio (1.07\u00b10.13 vs. 1.14\u00b10.16, P = 0.049) were lower in Group 1.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>CSI may develop after primary pterygium surgery, particularly in patients with relatively higher preoperative ACA, longer HIL, and shorter height. Given that CSI can significantly increase both lower and higher-order aberrations, it is crucial to anticipate CSI probability and inform patients before surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313958","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T18:30:14Z","timestamp":1732041014000},"page":"e0313958","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Corneal steep island formation after primary pterygium surgery"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8153-1232","authenticated-orcid":true,"given":"Dong Hee","family":"Ha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1181-5112","authenticated-orcid":true,"given":"Kyoung Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"pone.0313958.ref001","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.exer.2015.01.010","article-title":"Fibroblast biology in pterygia","volume":"142","author":"KW Kim","year":"2016","journal-title":"Exp Eye Res"},{"issue":"4","key":"pone.0313958.ref002","first-page":"412","article-title":"Quantitative analysis of regular and irregular astigmatism induced by pterygium","volume":"18","author":"A Tomidokoro","year":"1999"},{"issue":"1","key":"pone.0313958.ref003","first-page":"58","volume":"41","author":"R Nejima","year":"2015","journal-title":"Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic 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anterior segment optical coherence tomography","volume":"101","author":"T Gasser","year":"2017","journal-title":"Br J Ophthalmol"},{"issue":"4","key":"pone.0313958.ref013","first-page":"434","article-title":"Analysis of pterygium size and induced corneal astigmatism","volume":"27","author":"PA Mohammad-Salih","year":"2008"},{"issue":"3","key":"pone.0313958.ref014","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00003226-199007000-00004","article-title":"Conjunctival pterygia. Mechanism of corneal topographic changes","volume":"9","author":"JB Oldenburg","year":"1990","journal-title":"Cornea"},{"issue":"2","key":"pone.0313958.ref015","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3928\/1081597X-20080201-06","article-title":"Corneal topographic changes after four types of pterygium surgery","volume":"24","author":"S Yilmaz","year":"2008","journal-title":"J Refract Surg"},{"issue":"11","key":"pone.0313958.ref016","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1097\/ICO.0000000000001341","article-title":"Long-Term Stability of Keratometry, Scheimpflug-Derived True Net Power, and Total Corneal Refractive Power After Primary Pterygium Excision","volume":"36","author":"KW Kam","year":"2017","journal-title":"Cornea"},{"issue":"2","key":"pone.0313958.ref017","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11020329","article-title":"Effect of Pterygium Removal Combined with Conjunctival Autograft on Corneal Parameters in Swept-Source Imaging","volume":"11","author":"MP Wi\u0105cek","year":"2022","journal-title":"J Clin Med"},{"issue":"8","key":"pone.0313958.ref018","first-page":"1793","article-title":"Monochromatic aberrations of the human eye in a large population","volume":"18","author":"J Porter","year":"2001"},{"key":"pone.0313958.ref019","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.2147\/OPTH.S21819","article-title":"Correlation between contrast sensitivity and higher-order aberration based on pupil diameter after cataract surgery","volume":"5","author":"T Yamaguchi","year":"2011","journal-title":"Clin Ophthalmol"},{"issue":"743543","key":"pone.0313958.ref020","article-title":"Evaluation of disk halo size and identification of correlated factors in myopic adults.","volume":"9","author":"W Zhao","year":"2022"},{"issue":"1184318","key":"pone.0313958.ref021","article-title":"The influence of pterygium on corneal densitometry evaluated using the Oculus Pentacam system","volume":"10","author":"J Zhang","year":"2023","journal-title":"Front Med (Lausanne)."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313958","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T18:30:23Z","timestamp":1732041023000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313958"}},"subtitle":[],"editor":[{"given":"Nader Hussien Lotfy","family":"Bayoumi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":21,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313958","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}