Pterygium

There are several indications for performing pterygium surgery:

• Surgery should be performed before the pterygium extends onto the central cornea. Once it reaches the central cornea (the visual axis), scarring can permanently reduce vision.
• The pterygium may cause frequent irritation, especially in dry, windy or dusty conditions.
• The pterygium may be cosmetically unsatisfactory.
• Occasionally, abnormal pre-cancerous (dysplastic) or cancerous changes develop within or adjacent to the pterygium. Treatment options for these lesions include anti-cancer drops or surgery.

All excised lesions, whether thought to be cancerous or non-cancerous, are submitted for examination by a Pathologist (a medical specialist with expertise in the examination of tissue samples).

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Pathological assessment establishes a diagnosis, assesses whether the specimen has been completely removed and looks for features that may increase the risk of recurrent disease (such as invasion of nerves and blood vessels by cancerous tissue).

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If the lesion is cancerous and appears not to have been removed completely, additional surgery may be required to remove additional tissue. Alternatively, drops may be prescribed to treat the cancerous change.

Surgery is performed in hospital as a day patient, usually under local anaesthetic with intravenous sedation.

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An operating microscope gives a magnified view of the delicate tissues of the eye. After anaesthetic injection, the pterygium is gently dissected from the cornea (the clear optical portion at the front of the eye) and from the adjacent portion of the eye.

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A conjunctival skin graft is then taken from under the upper or lower eyelid and sutured (or sometimes glued) into place over the white portion of the eyeball. A contact lens is applied for pain relief and the eye is padded closed.

• Whenever possible prior to your surgery and with your consent, clinical photographs will be obtained of the condition necessitating surgery.
• A detailed examination of the eyes and eyelids will be performed. This will include the visual acuity and intraocular pressures of the eyes. Wherever possible, this examination will also include pupil dilation and use of the slit lamp biomicroscope to assess the internal health of the eyes.
• You may be asked to see you General Practitioner for a preoperative assessment, including an ECG and basic blood tests (Full Blood Count, Electrolytes). A chest X-ray is not usually required.

The goals of surgery include:

• the permanent removal of the pterygium,
• preservation of good sight,
• elimination an unsightly eye growth; and
• in the case of an atypical pterygium, removal of the cancerous or precancerous lesion.