Pterygium Removal
Pterygium Surgery
WHAT IS A PTERYGIUM?
Pterygium (pronounced tur-IJ-ee-um) is a benign growth on the cornea (the clear front window of the eye) and the conjunctiva - the thin, filmy membrane that covers the white part of your eye (sclera). These wing shaped growths typically begin on the inner aspect of the eye and slowly grow across the cornea. As they grow across the eye they can irreversibly damage the cornea underneath. Pterygiums are believed to be caused by dry eye, exposure to wind and dust and UV (ultra-violet) exposure.
WHAT ARE TREATMENT ALTERNATIVES?
In some cases no treatment is needed. Sometimes eye drops and ointments may be used to reduce inflammation (swelling). If the growth is growing and threatens sight or causes persistent discomfort, it can be removed. You should understand that despite proper surgical removal, the pterygium may return. If a pterygium returns, additional surgery may be necessary, particularly if there is persistent inflammation or progression of the new growth towards the center of vision.
HOW WILL REMOVING THE PTERYGIUM AFFECT MY VISION?
The goal of pterygium excision (removal) is to decrease irritation/inflammation, achieve a normal, smooth ocular surface, improve the decreased vision caused by the pterygium, and prevent regrowth, if possible. Pterygium surgery is typically performed to reduce the chance of vision loss but in some cases may actually restore some vision that has already been lost.
WHAT IS MITOMYCIN-C?
Mitomycin-C (MMC) is a medication that may be used during excision (removal) to minimize the recurrence of pterygium. MMC was first used as anti-cancer drug. Ophthalmologists use MMC for other purposes “off-label” as part of the practice of medicine in many laser procedures. The decision to use MMC is based on the evaluation of the advantages and potential disadvantages in each individual case.
WHAT IS CONJUNCTIVAL TRANSPLANTATION?
Conjunctival transplantation moves a piece of your own conjunctiva (filmy white part of the eye) to the area where the pterygium is excised (removed). This technique is used to greatly reduce the risk of recurrence. With this technique the chance of recurrence is less than 5%. Typically serum tissue glue (Tisseel or Artiss) is used to secure the transplanted tissue. Occasionally absorbable sutures can be used but tend to be more uncomfortable.
POST OPERATIVE COURSE
Patients will often have pain on the night of the procedure but this typically improves greatly each following day. Pain medications may be used orally and will be prescribed by Dr.Bujak. Often patients only need them for the first night. Some minor irritation and red eye commonly persists for several weeks. Patients typically use eye drops for 6 weeks after surgery to minimize risk of infection and inflammation.
RISKS OF SURGERY
As with any surgery there is small risk of infection and eye drops are used to minimize this. There is also a very small risk of double vision, scarring, as well as risk of scleral thinning if the medication MMC is used. The most significant risk is a 5% chance of recurrence of the pterygium.