Evaluation of the effects of pterygium and pinguecula excision on dry eye disease

INTRODUCTION & OBJECTIVE: The aim of this study is to evaluate changes in the symptoms and signs of dry eye disease in patients who underwent pterygium and pinguekula excision, and to determine the appropriate timing for surgical intervention in the management of the disease. METHODS: This study was designed as a single-center, retrospective, cross-sectional, comparative study. Patients who presented to Akdeniz University Hospital Ophthalmology Clinic between January 2022 and March 2025 with a diagnosis of pterygium or pinguekula and underwent surgical excision were included. Dry eye symptoms were evaluated before and after surgery. The size of the pterygium and pinguekula lesions was measured via slit-lamp biomicroscopy. Dry eye parameters such as Schirmer test, tear breakup time (BUT), tear meniscus height, and corneal and conjunctival staining were assessed. RESULTS: The postoperative OSDI scores at months 1, 3, and 6 significantly decreased in both the pterygium and pinguekula groups (p < 0.001). Postoperative Schirmer test values showed a statistically significant increase compared to preoperative values in both groups (p < 0.05). A significant improvement in BUT was observed only in the pinguekula group (p < 0.001), demonstrated by an increased number of patients with BUT values over 5 seconds in the postoperative period. No statistically significant change in BUT was found in the pterygium group (p = 0.274). Tear meniscus height increased significantly in the pterygium group (p < 0.001), while no significant change was observed in the pinguekula group. Conjunctival staining findings changed significantly in both groups (p < 0.001). In the pterygium group, the number of patients without corneal staining significantly increased at postoperative month 3 and month 6 compared to the preoperative period (p < 0.001). However, such improvement was not observed in the pinguekula group. DISCUSSION & CONCLUSION: Previous studies have reported that pterygium excision leads to a decrease in dry eye symptoms and improvement in clinical findings. Consistent with the literature, our study showed reduced symptoms and improved clinical signs of dry eye following pterygium excision. Although the association between pinguekula and dry eye is recognized, studies investigating the effects of pinguekula excision on dry eye disease are limited. In our study, symptom scores decreased, OSDI scores declined, Schirmer and BUT values increased, and clinical signs improved at postoperative months 1, 3, and 6 following excision.