Pterygium Surgery

Symptoms

• Persistent redness and a foreign-body sensation
• Dryness, burning and irritation, worse in wind, sun and dust
• A visible fleshy growth extending from the corner towards the cornea
• Blurring and increasing astigmatism as the lesion advances
• Restricted eye movement in very advanced cases

When is surgery indicated?

Not every pterygium requires surgery. Indications include progression towards the visual axis, induced astigmatism affecting vision, recurrent inflammation not controlled with medical treatment, restriction of eye movement, and — in some patients — appearance. Small, quiet lesions are managed with lubricants, sun protection and observation.

Surgical technique

The pterygium is removed and the bare area is covered with a conjunctival autograft — a thin piece of the patients own conjunctiva taken from beneath the upper lid and secured with fine sutures or tissue adhesive. Simple excision leaving bare sclera has a substantially higher recurrence rate and is not the preferred technique. In selected cases an amniotic membrane graft or adjunctive treatment is used. The procedure is performed under local anaesthesia as a day case, typically in 30–45 minutes.

Recovery

Foreign-body sensation, watering and redness are expected in the first days and settle progressively. Drops are used for several weeks as prescribed. Redness of the graft area may take weeks to months to fade. Dust, water contact and eye rubbing are avoided in the early period, and sunglasses are recommended long term.

Recurrence

Recurrence is the main issue in pterygium surgery. It is more likely in younger patients, in fleshy, actively inflamed lesions, and after bare-sclera excision. Consistent ultraviolet protection after surgery reduces the risk. If a pterygium recurs, treatment is planned differently from the first operation.

Note: a pterygium is not a cancer. However, any unusual, rapidly growing or pigmented lesion on the ocular surface should be examined, as other conditions can look similar.

Frequently asked questions

Does every pterygium need surgery?

No. Small, quiet lesions are observed with lubricants and sun protection. Surgery is for progression, induced astigmatism or persistent inflammation.

Will it come back?

Recurrence is possible. A conjunctival autograft substantially lowers the risk compared with bare-sclera excision, and UV protection helps.

Is the operation painful?

It is done under local anaesthesia. Foreign-body sensation and watering are expected for a few days afterwards.

Does a pterygium turn into cancer?

No. It is a benign growth, but any unusual or pigmented ocular surface lesion should be examined.

Medically reviewed by

Op. Dr. Alim Hüseynov — Ophthalmologist — refractive laser surgery, cornea and oculoplastic surgery, Nişantaşı Hastanesi Göz Merkezi. Our doctors

This page is for general information and does not replace an examination by a doctor. Treatment decisions are made after examination and diagnostic tests.