What is Pterygium?
Pterygium is a non-cancerous growth of the conjunctiva—the clear, thin tissue covering the white part of the eye. This condition usually begins on the nasal side of the eye and can gradually extend over the cornea. While pterygium may be asymptomatic in the early stages, larger growths can cause discomfort, redness, tearing, and even visual impairment if they encroach on the cornea.
Causes and Risk Factors
Pterygium is strongly associated with prolonged exposure to ultraviolet (UV) radiation from the sun, making individuals who live in sunny climates or spend a lot of time outdoors more susceptible. Other contributing factors include chronic eye irritation from dust, wind, or dry environments. The condition is more common among adults, especially those between the ages of 20 and 50.
Symptoms of Pterygium
While a small pterygium might not cause significant issues, larger or progressive growths can lead to:
- Persistent redness and irritation
- A gritty or foreign body sensation in the eye
- Dryness and tearing
- Blurred vision (if the growth affects the cornea)
- Astigmatism due to corneal distortion
In advanced cases, the pterygium can obscure the visual axis, leading to serious vision problems.
Surgical Treatment: Pterygium Excision with Autograft
When a pterygium causes significant symptoms or threatens vision, surgical removal is often recommended. The most advanced and effective treatment involves pterygium excision with autograft. This procedure not only removes the abnormal tissue but also replaces it with a graft taken from the patient’s own conjunctiva to prevent recurrence.
The Procedure
1. Preparation: The procedure is usually performed under local anesthesia. This ensures the patient remains comfortable.
2. Excision: We carefully remove the pterygium from the conjunctiva and cornea. Precision is key to avoid damaging surrounding healthy tissue and the use of advanced techniques is necessary to ensure a clear post operative surface.
3. Autografting: Once the pterygium is excised, a piece of healthy conjunctival tissue, the autograft, is harvested from another part of the same eye, typically the superior region. This graft is then placed over the area where the pterygium was removed, covering the bare sclera.
4. Securing the Graft: The graft can be secured in place either with sutures or tissue adhesive (fibrin glue).
Benefits of Autograft
The primary advantage of using an autograft is the significantly lower risk of pterygium recurrence compared to older methods of bare sclera excision. Recurrence rates with autograft are around 5-15%, whereas, without the graft, they can be as high as 50-80%. Additionally, the use of the patient’s own tissue minimizes the risk of rejection or infection.
Postoperative Care
Following pterygium excision with autograft, patients are prescribed antibiotics and anti-inflammatory drops to prevent infection and control inflammation. No patch is used over the eye. Healing typically occurs over a period of 2-4 weeks.
Why Choose Pterygium Excision with Autograft?
Pterygium excision with autograft is considered the gold standard in treating moderate to advanced pterygium for several reasons:
- High success rate: The risk of recurrence is much lower compared to other techniques.
- Minimally invasive: The use of the patient's own tissue results in faster healing and less discomfort.
- Better aesthetic outcome: The autograft helps restore the normal appearance of the eye after pterygium removal.
Conclusion
If left untreated, pterygium can lead to significant discomfort and visual impairment. However, with modern surgical techniques like excision with autograft, patients can achieve long-lasting relief and a low risk of recurrence. As an experienced oculoplastic eye surgeon, I am committed to delivering precise and effective care for patients suffering from this condition. If you are dealing with the discomfort or visual issues caused by pterygium, schedule a consultation to explore your treatment options.
Eye and Eyelid clinic
