What is a pterygium ?
A pterygium (a “wing” in Latin) is a layer of vascular tissue which grows from the conjunctiva onto the cornea, usually on the nasal (inner) side of the eye. It usually grows slowly and painlessly but may become aggressive at some stage. A small pterygium is barely visible, but a larger one may be red and ugly, cause irritation, tearing and seriously affect the vision. Nevertheless, It is rare for it to reach the center of the cornea.
We do not know what causes a pterygium to appear or how to prevent it but once it has appeared,dust, sunshine may influence its rate of growth. It is recommended to wear sunglasses and to use lubricating eye drops, which may be purchased without a prescription. If the pterygium is inflamed, your ophthalmologist may prescribe non- steroid anti-inflammatory eye drops.
Not every pterygium requires surgery. One must bear in mind that the pterygium sometimes recurs after being removed – sometimes more actively than the original condition. Indications for surgery include:
A large pterygium affecting the vision.
Significant symptoms such as redness, irritation and tearing.
Progression of the pterygium toward the center of the cornea, documented by regular examinations.
The operation is performed using the operating microscope and the patient is sent home immediately after surgery. The pterygium is separated from the cornea and conjunctiva to which it was attached, the exposed cornea is polished using a diamond burr to completely remove all scar tissue. In order to prevent a recurrence a chemotherapeutic agent such as Mitomycin C is applied to the cornea. The bare sclera is covered with a conjunctival graft taken from the upper part of the same eye. The graft is secured in place with very fine sutures or (more commonly today) with a bio-glue – the same material which is used to prevent bleeding in cardiac and brain surgery. The graft ensures rapid, painless healing and (together with the use of the chemotherapeutic agent) prevents recurrence in nearly all cases.
The advantages of using glue rather than sutures include:
No irritation from sutures.
No need to remove sutures.
Rapid, painless healing and a good cosmetic result.
A patient after removal of a pterygium using bio-glue