Pterygium is a common eye condition that may require surgical intervention. This non-cancerous growth on the conjunctiva, the clear membrane covering the white part of the eye, can extend onto the cornea, the transparent front part. When a pterygium causes symptoms or affects vision, surgery becomes a consideration to remove the growth and restore eye health.
Understanding Pterygium
A pterygium typically appears as a fleshy, triangular or wedge-shaped growth, often originating from the nasal side of the eye. This condition is often linked to chronic exposure to ultraviolet (UV) radiation, dust, and wind, especially in warm, dry climates.
While often benign, a pterygium can cause uncomfortable symptoms. Individuals might experience persistent redness, irritation, or a foreign body sensation. If the growth extends over the cornea and approaches the pupil, it can distort the corneal surface, leading to blurred vision or induced astigmatism.
When Surgery is Recommended
Surgery is typically recommended when the growth interferes with vision, such as causing significant astigmatism or obscuring the pupil. It may also be advised for chronic irritation, redness, or discomfort unresponsive to conservative treatments like eye drops.
Cosmetic concerns can also prompt surgery if the visible growth causes distress. Rapid growth or progression towards the cornea’s center also warrants early removal to prevent severe vision impairment. While non-surgical treatments can alleviate symptoms, they do not prevent the pterygium from growing or remove it.
The Surgical Process
Pterygium removal is usually an outpatient procedure, meaning patients can return home the same day. The surgery is performed under local anesthesia, ensuring comfort and eliminating sensation in the eye. The abnormal tissue is carefully excised from the surface of the eye.
A common technique involves excision with a conjunctival autograft. After removal, a small piece of healthy conjunctival tissue is harvested from another area of the patient’s own eye, often from under the upper eyelid. This autograft is then transplanted to cover the removed area, significantly reducing recurrence risk. The graft can be secured using sutures or a tissue adhesive like fibrin glue, offering quicker, more comfortable recovery.
Recovery and Post-Operative Care
Following surgery, patients can expect common sensations during initial healing. Mild discomfort, a gritty feeling, redness, and light sensitivity are typical, and vision may be temporarily blurry. These symptoms usually subside within a few weeks, though redness can persist for up to six weeks.
Post-operative care requires strict adherence to the ophthalmologist’s instructions for proper healing and to minimize complications. This includes prescribed eye drops, such as antibiotics to prevent infection and anti-inflammatory or steroid drops to reduce swelling and irritation. Patients are advised to wear an eye patch or shield, especially during sleep, for protection and to avoid rubbing the eye. Activities like swimming, heavy lifting, and exposure to dusty or windy environments should be avoided for several weeks.
Minimizing Recurrence Risk
Despite successful surgery, pterygium can regrow, though modern techniques have greatly reduced this risk. Surgical method plays a significant role; for instance, conjunctival autografting has a lower recurrence rate than simply excising the growth without a graft. Studies indicate that recurrence rates with conjunctival autograft range from approximately 2% to 10.7% for primary cases. Younger patients tend to have a higher risk of recurrence.
Long-term preventive measures are important for minimizing recurrence. Consistent protection from ultraviolet (UV) radiation is recommended, including high-quality sunglasses that block UVA and UVB rays, and wide-brimmed hats outdoors. Adherence to post-operative eye drop regimens and regular follow-up appointments are important for monitoring healing and detecting early signs of regrowth.