Pterygia
Surgical treatment
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| Large pterygia that threaten vision require surgical removal |
In some patients pterygia must be removed surgically.
Reasons to remove pterygia
The most common reasons pterygia are removed are:
- Unacceptable appearance
- Symptoms not controlled by medical treatments
- Corneal distortion, scarring or growth over the pupil
- Concern the growth may not be simply a pterygium but a tumour of the conjunctiva
Pterygium surgery
Pterygium surgery requires careful planning and meticulous surgery. Research has shown that the best way to deal with pterygia is to:
- Remove the abnormal tissue
- Cover the bare underlying sclera with a small piece of conjunctival tissue taken from under the upper eyelid. This tissue is known as an autologous conjunctival graft.
- Treat the eye with topical steroids for a prolonged period after the surgery
- Consider the use of additional treatment such as Mitomycin C, a drug that reduces scarring and lessens the likelihood of pterygium recurrence
Removal of the pterygium
Removing pterygia is a very straightforward process. Only local anaesthesia is required.
Autologous conjuctival grafting
If pterygia are simply removed and the area left to scar, recurrence will occur in approximately one third of all patients. Covering the area with a piece of conjuctival tissue reduces the recurrence rate down to approximately 5%.
Free conjunctival grafts are taken from the surface of the eye covered by the upper eyelid and are sutured or glued into place; a time consuming process. The harvest bed regenerates.
Post operative care
It is very important to minimise post operative inflammation following pterygium surgery. It is common to use steroid eye drops for up to three months.
Mitomycin C
Mitomycin is an anti-scarring drug that is sometimes used to minimise the risk of pterygium recurrence. Mitomycin drops are used for several weeks, beginning a week after surgery.