PTERYGIUM SURGERY

What is a pterygium?

A pterygium is a wedge-shaped fibrovascular growth of conjunctiva (the surface tissue of the white of the eye) that extends onto the cornea. Pterygia are benign lesions that can be found on either side of the cornea.

What causes a pterygium to form?

It is thought that prolonged exposure to ultraviolet light may contribute to the formation of pterygia. Pterygia are more often seen in people from tropical climates, but can be found in others as well.

What symptoms would I have from a pterygium?

Pterygia are often asymptomatic, and many do not require immediate treatment. However, some pterygia become red and inflammed from time to time. Large or thick pterygia may bother some people due to a persistent foreign body sensation in the eye.

What is the treatment for a pterygium?

This depends largely on the size and extent of the pterygium, as well as its tendency for recurrent inflammation. Evaluation by an ophthalmologist will help determine the most optimal treatment in each case. If a pterygium is small but becomes intermittently inflammed, your ophthalmologist may recommend a trial of a mild steroid eye drops during acute inflammatory flares. If these drops are recommended, you should remain under the care of your ophthalmologist to ensure that you do not develop side effects from the use of these medications. In some cases, your ophthalmologist may recommend surgical removal of the tissue.

When should a pterygium be surgically removed?

This will depend largely on the judgment of your physician. Removal will likely be advised if the pterygium is growing far enough onto the cornea to threaten your line of vision. Pterygia may also be removed if they cause a persistent foreign body sensation in the eye, or if they are constantly inflammed and irritating. In addition, some pterygia grow onto the cornea in such a way that they can pull on the surface of the cornea and change the refractive properties of the eye, causing astigmatism. Pterygium surgery may decrease the astigmatism.

What is involved in the surgical removal of a pterygium?

The removal may take place in an operating room. The pterygium is carefully dissected away. In order to prevent regrowth of the pterygium, your ophthalmologist may remove some of the surface tissue of the same eye (conjunctiva) and suture or glue it onto the bed of the excised pterygium. Alternatively, an antimetabolite such as mitomycin may be applied to the site. Postoperatively, your ophthalmologist may recommend some steroid eye drops for several weeks to decrease the inflammation and prevent regrowth of the pterygium.

No-stitch Pterygium/Autograft Surgery:

The surgery is performed under local or general anaesthetic in theatre. The procedure takes about 30 min. Essentailly the abnormal tissue or pterigium is removed and the defect that remains is closed with tissue from underneath the eyelid. This is glued in place with a modern tissue adhesive called TISSEEL. After about a week the adhesive dissolves with no residue at all.

Advantages of this technique are:

  • Time spent in theatre is between 10-15 minutes shorter per eye.
  • Post operative pain and recovery is improved.
  • (Most important) Postoperative results are better than previous techniques with the recurrence less than 2% (with routine techniques it is 10-15%).