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A pterygium (ter-e-je-um), is a fleshy tissue that grows over the cornea. While the exact cause is not well understood, they occur more often in people who spend a great deal of time outdoors, especially in sunny climates like Las Vegas. When a pterygium becomes red and irritated, eye drops or ointments may be used to help reduce the inflammation. If the pterygium is large enough to threaten sight, grows or is unsightly, it can be removed surgically in an in office procedure. Despite proper surgical removal, the pterygium may return, particularly in young people. Surface radiation or medications (like Mitomycin -C) are sometimes used to help prevent recurrences. |
Pterygium Surgery
Pterygium surgery can be peformed in our office surgery center and is surprisingly painless. Eyedrops are used to anesthetize the surface of the eye, after which a small device is inserted to hold the eyelids apart. A little anesthetic is then injected into the fleshy part of the pterygium, elevating it from the surface of the eyeball, after which the pterygium is peeled away. Usually no sutures are required.
POST-OP:
An eye patch is generally worn for one or two days. The eye may be red for up to two weeks, but ultimately there is almost no scar. If pterygia are present in both eyes, usually the second eye is operated at least one week after the first.
RECURRENCE:
Even though they are not malignant or dangerous, up to 40% of excised pterygia can eventually grow back unless extra measures are taken to prevent this. This is especially likely if the irritation which caused it is still present (dryness or excessive sunlight) and if the pterygium was very thick and red to begin with.
We have been pleased with our results with an investigational medicine called Mitomycin. When this medication is used during the surgery the recurrence rate drops to about 5%. This medication is usually well tolerated with no side effects. Possible side effects include delayed healing, sometimes with actual atrophy or withering away of the tissue in the bed of the pterygium.
RECOMMENDATION:
If your pterygium is very small and does not bother you, then you should try using mild, soothing eyedrops such as Murine or Visine or one of the many so-called artificial tears such as Tears Naturale or Hypotears. These could be used up to four times daily on dry or smoggy days when your eyes are likely to become red. Try to keep your eyes from becoming red, because that is a sign of the inflammation which tends to make pterygia grow larger. Wearing sunglasses when you are out in bright sunlight is also helpful.
If you wish to have the pterygium excised, you should plan on being off from work for one week. (You can safely return to work immediately if you wish, but usually the eye is quite red for about a week). When you come for the procedure, have someone accompany you who can drive you home. Ice bags and pain pills are advised for the first day, but after that you just need to instill antibiotic-steroid eyedrops four times daily for two weeks.
