To examine the cosmetic outcome of femtosecond laser-assisted pterygium surgery (FLAPS) with conjunctival autograft (CAG) and its potential predictive factors. This was a prospective interventional case series (NCT02866968). We included 29 patients (29 eyes) with primary pterygium who underwent FLAPS. Cosmetic outcome was graded by two graders (an ophthalmology resident and an experienced ophthalmologist) using Hirst classification system (1–4 = excellent–poor). Weighted Cohen’s kappa analysis was performed to examine the intra- and inter-rater reliability. The relationship between cosmetic outcome and various factors were determined by Spearman’s correlation coefficients (r). The preoperative severity of pterygium (Tan grading system) was mild/atrophic (7%), moderate/intermediate (62%), and severe/fleshy (31%). An ultrathin CAG (mean thickness of 74.5 ± 9.8 μm) was fashioned intraoperatively. An excellent cosmetic outcome of FLAPS (median ± IQR) was observed at 3 months (1.0 ± 1.0) and remained similar at 6 months (1.0 ± 0.0) and 12 months (1.0 ± 0.0) postoperatively. At final follow-up, 27 (93%) patients achieved good-to-excellent cosmetic outcome, with 1 (3%) patient having a poor outcome due to incomplete pterygium removal. Weighted kappa analysis of Hirst grading system showed excellent intra-rater (κ = 0.86–0.95) and inter-rater reliability (κ = 0.84–0.88). There was a weak and borderline significant correlation between good cosmetic outcome and reduced postoperative CAG thickness (r = 0.38, P = 0.06) but not with age, gender, preoperative pterygium severity, or intraoperative CAG thickness. FLAPS can result in an excellent cosmetic outcome, which may be attributed to the beneficial effect of an ultrathin CAG. ClinicalTrials.gov , NCT02866968 . Registered in July 2016,

中文翻译：

---

飞秒激光辅助翼状surgery肉手术的美容效果

要研究飞秒激光辅助翼状pt肉联合结膜移植（CAG）的美容效果及其潜在的预测因素。这是一个前瞻性干预案例系列（NCT02866968）。我们纳入了29例接受了FLAPS治疗的原发性翼状29肉患者（29眼）。美容结局由两名评分员（眼科住院医师和经验丰富的眼科医生）使用Hirst分类系统（1-4 =极差-差）进行分级。进行加权Cohen的kappa分析以检验评定者内部和评定者之间的可靠性。美容效果与各种因素之间的关系由Spearman相关系数（r）确定。翼状肉的术前严重程度（Tan分级系统）为轻度/萎缩性（7％），中度/中度（62％）和重度/肉质（31％）。术中形成了超薄的CAG（平均厚度为74.5±9.8μm）。术后3个月（1.0±1.0）观察到FLAPS的美容效果极好（中值±IQR），术后6个月（1.0±0.0）和12个月（1.0±0.0）仍相似。在最后的随访中，有27名（93％）的患者取得了良好至出色的美容效果，其中1名（3％）的患者由于翼状肉去除不彻底而导致效果不佳。Hirst分级系统的加权kappa分析显示出色的内部评估者（κ= 0.86-0.95）和内部评估者可靠性（κ= 0.84-0.88）。良好的美容效果与术后CAG厚度减少之间存在弱且临界的显着相关性（r = 0.38，P = 0.06），但与年龄，性别，术前翼状severity肉严重程度或术中CAG厚度无关。FLAPS可以带来出色的美容效果，这可能归因于超薄CAG的有益作用。ClinicalTrials.gov，NCT02866968。于2016年7月注册，