Web-based grading system focuses on appearance of eye after pterygium surgery

Ophthalmology. 2011;118(9):1739-1746

A study using a standardized Web-based grading system found that both laypeople and ophthalmologists were unable to differentiate pterygium surgery patients from patients who had received no surgery.

"As recurrence rates after pterygium surgery improve, the focus of attention is now directed more toward the postoperative appearance of the eye," the study author said.

An online system was created to grade the aesthetic appearance of the eye after pterygium extended removal followed by extended conjunctival transplant.

Six laypeople and six corneal specialists passed a trial grading test of 40 images with weighted kappa of 0.70 to 0.85. Intraobserver reliability scores were 0.86 to 0.95 for laypeople and 0.90 to 0.92 for the specialists.

Neither laypeople nor specialists could distinguish between online images of postoperative eyes and those in the control group. Ninety-four percent of all pterygium surgery eyes were graded as acceptable in what the author called a "robust and user friendly" grading system.

"Because the operated eyes could not be distinguished from normal control eyes, and because there are virtually no recurrences using this method, the time has come when patients could be offered pterygium surgery using this method to address the concern with the poor appearance of the eye," the study author said.