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Operation for Pterygium

  • Posted on- Apr 17, 2018
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Pterygium is a benign thickening of the outer coating (conjunctiva) of the eye that grows onto the cornea. As a pterygium grows, it may become red and irritated.


Eventually, it may cause visual disturbances by disrupting the normally smooth surface of the cornea. In severe cases, a pterygium can block a patient's vision altogether.


Pterygium surgery can be performed under local anesthesia (awake) or general anesthesia (asleep). The choice is based on the anticipated length and difficulty of the operation, the patient’s suitability for different sorts of anesthesia, his own preferences and the surgeon's advice.


A routine pterygium operation would be expected to last about 45 minutes and can usually be performed comfortably under local anesthetic.


Conversely, a recurrent pterygium (that has re-grown after a previous operation) usually needs more extensive surgery and a general anesthetic is recommended.


The patient will usually be able to go home on the day of his operation, but he may be asked to return for an eye check on the following day.


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Treatment of Pterygium


Pterygiums are usually caused by extended exposure to sunlight. They may remain stable after appearing or they may grow and affect vision.


Treatments include eye drops for irritation and redness, protection from sunlight and dust to prevent the pterygium from worsening, and occasionally steroids to lessen inflammation.


If the pterygium grows into the central cornea, surgical removal is recommended. This prevents the pterygium from altering the cornea's shape and affecting vision.


Pterygium Surgery


In surgery, the pterygium is removed and a small piece of the conjunctiva, which is the thin transparent skin that covers the white of the eye is placed on this site from under the upper lid.


The surgery is performed under local anesthetic. There should be no pain during the surgery, which takes approximately half an hour.


Following the procedure, a prescription is given for eye ointment or eye drops and analgesic tablets. For approximately 1-2 weeks following surgery, getting water, dust or dirt into the eye should be avoided.


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Re-growth may occur


In traditional "bare sclera" pterygium removal, the underlying white of the eye (sclera) is left exposed. Healing occurs over two to four weeks with mild to moderate discomfort.


Unfortunately, the pterygium may grow back, sometimes larger than its original size. The specialists have the solution to stop this recurrence.



Conjunctival Autograft with Stitches


The cornea specialists perform pterygium surgery with a conjunctival autograft because of a reduced risk of recurrence.


Procedure: - Here the pterygium is removed, and the cornea regains clarity. However, the gap in the mucous membrane (conjunctiva) tissue where the pterygium was removed is filled with a transplant of tissue that has been painlessly removed from underneath the upper eyelid.


Although the procedure requires more surgical skill than traditional surgery, this "auto-graft" (self-transplant) helps prevent re-growth of the pterygium by filling the space where abnormal tissue would have re-grown.


The autograft is held in place with tiny stitches that may dissolve after a few weeks or can be removed in the surgeon's office. Stitches on the eye frequently cause discomfort. The desire for a quicker, more painless recovery has led to the development of no-stitch pterygium/autograft surgery.



No-stitch Pterygium/Autograft Surgery


No-stitch pterygium/autograft surgery allows most patients to return to work within one or two days of surgery. A major advantage found in patients undergoing no-stitch surgery had significantly less pain after surgery than those having traditional surgery.


The no-stitch technique also reduced surgery time from an average of 20 minutes. No pterygium recurrences were found in any patients in the study.


Procedure: - Here the patient is lightly sedated to ensure comfort, and the eye is completely numbed, so there is no way to see the surgery occurring and no sensation of discomfort. The abnormal corneal tissue is removed and replaced with a thin graft of normal tissue. Over the next 2-3 weeks, the eye gradually returns to a normal appearance.


No-stitch surgery is made possible by the use of modern tissue adhesive. Composed of clotting proteins normally found in human blood, tissue adhesive allows the surgeon to secure a conjunctival autograft in seconds rather than minutes.


After about one week the tissue adhesive dissolves with no residue, leaving the eye to heal comfortably. Although tissue adhesive is derived from human blood products, no cases of blood-borne infection have ever been reported among millions of patients treated with this material in heart and lung surgery.


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Benefits of Pterygium Surgery


The main reason for removing a pterygium is to prevent future loss of eyesight by stopping the pterygium from growing over the central area of the cornea.

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