Pterygium Removal Surgery

What pterygium removal surgery involves

Pterygium removal surgery is a procedure to excise the abnormal fibrovascular tissue growing from the conjunctiva onto the cornea, and to reconstruct the surface so the growth is unlikely to return. It is recommended when a pterygium affects vision, advances toward the center of the cornea, causes persistent discomfort, or is cosmetically bothersome.

The modern technique: excision with conjunctival autograft

The current standard of care is not simply to cut the pterygium away. After the growth is removed, the bare area is covered with a thin graft of healthy conjunctiva taken from the patient’s own eye (a conjunctival autograft). This graft is secured with tissue glue rather than sutures. Replacing the abnormal tissue with healthy tissue is what gives this method its low recurrence rate, while the glue avoids the discomfort and inflammation caused by stitches.

Step by step

The eye is numbed with local anesthetic drops and a gentle injection around the operative area, so the procedure is painless. The surgeon carefully removes the pterygium tissue while preserving the surrounding healthy structures. A matching graft of conjunctiva is then harvested and positioned over the bare sclera, fixed in place with tissue glue. In selected higher-risk cases, an agent such as mitomycin-C may be applied to reduce the chance of regrowth. A protective dressing is placed for the first day.

Benefits and risks

Success rates are high, particularly with the autograft technique. As with any surgery there are risks: the main one is recurrence, especially in patients who continue to have heavy UV or environmental exposure. Less common effects include irritation, inflammation, and — rarely — corneal scarring or astigmatism. Significant complications are uncommon in experienced hands.

Recovery

Recovery generally spans a few weeks. Redness, tearing and mild discomfort are normal in the first one to two weeks, and vision may be slightly blurred initially. Anti-inflammatory and lubricating drops are prescribed, and it is important to protect the eye from sun, avoid rubbing it, and stay away from dusty environments and strenuous activity during early healing.

Choosing a surgeon

Because recurrence and cosmetic outcome depend heavily on technique and experience, choosing a dedicated cornea surgeon matters. Prof. Michael Mimouni, former Chairman of the Israeli Cornea Society and Director of the Cornea Unit at Rambam Health Care Campus, performs pterygium surgery using modern, suture-free autograft methods.