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Pterygium Removal

Introduction

A Pterygium is a pink triangular shaped growth of tissue over the cornea. In some people, the growth of pterygia is slow and happens throughout the person’s life span, while for others, it stops after a certain time. It usually is not noticeable unless it becomes red due to dust or other pollutants.

In very rare cases, it has been seen that a Pterygium can grow large enough to cover the pupil of the eye. People living in sunny climates are more prone to getting the disease.

Causes

The main cause why a pterygia develops is increased exposure to UV-Light or a History of the Disease in the Family.

A pterygium can be present as a range of fibrovascular changes on the surface of the conjunctiva and the cornea. The pterygium is more commonly found to be present on the nasal conjunctiva and to extend onto the nasal cornea, although it can be present in other locations as well.Pterygia is usually observed to see how much the tissue would grow. Surgery is recommended for cosmetic reasons or if it starts to obstruct vision.

There are multiple procedures that have been advocated for the treatment of this condition. The kind of treatment depends on the severity of Pterygia. Procedures range from a simple excision to sliding flaps of conjunctiva with or without beta radiation therapy.

In cases of aggressive Pterygia free grafts of conjunctiva are used simultaneously while doing a primary excision of the lesion. For moderate Pterygia cases, conjunctival autografts and amniotic membrane transplants may be used by the surgeon. The conjunctival autografts and the amniotic membrane transplants are sutured onto the adjacent conjunctiva and sub-adjacent cornea. A corneal surgeon may sometimes seal the graft tissue onto the underlying sclera with the help of fibrin tissue glue rather than using sutures.

In cases where the Pterygium is mild, the patient is treated with lubricant eye drops which helps reduce the redness and irritation in the eye.

Procedure

Surgery for the removal of pterygia is usually done as an out-patient procedure under local anesthesia. Most corneal surgeons perform Pterygium Surgery with a conjunctival autograft because of a reduced risk of recurrence.

The surgeon removes the Pterygium helping restore clarity to the cornea. There is now a gap that is present in the conjunctival tissue after the removal of the Pterygium. The Surgeon skillfully removes part of a tissue from underneath the upper eyelid and fills the gap. This procedure helps prevent the re-growth of the Pterygium.

Associated Risks

Some of the risks associated are:

  • Distortion and/or reduction of central vision
  • Redness
  • Irritation
  • Chronic scarring of the conjunctiva and the cornea
  • Extensive involvement of the extraocular muscles may restrict ocular motility and contribute to diplopia

Postoperative complications of pterygium repair can include the following:

  • Infection
  • Reaction to suture material
  • Diplopia
  • Conjunctival graft dehiscence
  • Corneal scarring

Rare complications may include perforation of the globe, vitreous hemorrhage, or retinal detachment.

Recovery

Post-operatively, the eye is usually patched overnight and the patient would be administered antibiotics or anti-inflammatory drops or ointments. Apart from these, the patient would be advised to use Uv-light blocking sun glasses. This is done so as to reduce the exposure to further UV radiation.

Following an excision of Pterygia, the cosmetic and visual prognosis has found to be very satisfying. Most people are able to get back to normal activities within 48hours after the surgery.

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