Pterygium Excision

Understanding pterygium excision

Pterygium is a growth of fibrovascular connective tissue that develops on the cornea from the conjunctiva, often advancing toward the center of the cornea and affecting vision. It is far more common in areas with heavy sun, wind and dust exposure — placing Israel among the higher-incidence regions. Pterygium excision is the surgical procedure to remove this tissue and restore a healthy ocular surface.

Why excision alone is not enough

Historically, surgeons removed the pterygium and left the underlying sclera bare. While simple, this "bare-sclera" approach carries a high recurrence rate. Modern surgery therefore pairs excision with reconstruction: after the growth is removed, the area is covered with a graft of the patient’s own healthy conjunctiva.

Conjunctival autograft

The conjunctival autograft replaces the removed tissue with healthy tissue and is typically secured with tissue glue rather than sutures. This is the single most important factor in keeping recurrence low, and the glue technique reduces pain, inflammation and healing time compared with stitches. In selected higher-risk cases, agents such as mitomycin-C may be used to further discourage regrowth.

The procedure and recovery

Excision is performed under local anesthesia as a day procedure and is painless. Afterward, redness, tearing and mild irritation are expected for one to two weeks, and anti-inflammatory and lubricating drops are prescribed. Protecting the eye from UV, avoiding rubbing, and staying away from dust and strenuous activity during early healing all support a smooth recovery and a durable result.

Expertise matters

Recurrence and cosmetic outcome depend strongly on the surgeon’s technique and experience. Prof. Michael Mimouni, former Chairman of the Israeli Cornea Society, performs pterygium excision with modern autograft-based, suture-free methods designed to minimize recurrence.