Treatments & Surgery - Pterygium Surgery

Overview

Removal  of a pterygium can be undertaken to protect eyesight or to restore a normal appearance to an eye. The pterygium can only be removed with surgical techniques and cannot be taken off with laser or other technology.

Simple excision of the pterygium is generally not sufficient due to the high risk of regrowth,  approximately 45%. Various adjunctive techniques have been used over  the years to reduce the risk of regrowth after excision. In the past, radiotherapy was used but this resulted in severe problems in the sclera or white part of the eye a decade after treatment.  Another similar method has been to use mitomycin C, a chemotherapy agent. This has also been subject to similar problems.

Currently the most popular technique to reduce regrowth is called autoconjunctival grafting. After the pterygium is removed,  a small piece of tissue, the conjunctiva, is taken from underneath the upper eyelid. It is then stitched into place in the inner corner of the eye. Initially the graft is red and swollen but this gradually settles over three months and in most cases, a near normal appearance is achieved. The suture is generally removed after one week.  With this technique, regrowth rates drop to around 5-10%.

Pictured right: Autoconjunctival graft one month after removal of pterygium

The surgery is carried out as a day stay procedure in which the eye is put to sleep, whilst the patient remains awake. It takes about an hour to do the operation,  and the longest part is placing the graft. A pad is put on the eye and this is removed the next day. It is usual for quite significant discomfort to be experienced during the first few days after surgery.

Removal  of the suture is done easily in the office one week later. Eye drops will be required for up to three months after surgery and it is only after this time that the eye is starting to return to a normal appearance. Avoiding excessive sun exposure after surgery is important. It is very rare for a graft not to “take” and they do not reject as it comes from the same source.