Pterygium

A pterygium is fleshy tissue that grows over the cornea, It may remain small or may grow large enough to interfere with vision. Pterygium occurs more often in people who spend a great deal of time outdoors, especially in sunny climates. UV radiation (usually from sunlight) is the most common cause of pterygium. This explains why pterygium occurs with increasing frequency in climates approaching the equator.

Other causes include continuous exposure to dry, dusty environments. People who spend significant time in water sports (surfing or fishing) are particularly susceptible to pterygium because of the intense exposure to UV that occurs in these environments. When the eye is continuously assaulted by UV rays, the conjunctiva may thicken in a process similar to callus formation on the skin.

The sensitive structures of the outer eye often can not comfortably tolerate this degenerative process, and irritation, redness, foreign body sensation, and ocular fatigue can result .

The best method of preventing pterygium is to regularly wear UV 400 rated sunglasses when outdoors in sunny conditions.

Pterigión

Pterigión

Sunglasses with a wrap-around design provide better protection than those with large gaps between the sunglass frame and the skin around the eyes.
Wearing a hat with a wide brim provides valuable additional protection.
When a pterygium becomes red and irritated, eyedrops or ointments may be used to help reduce
the inflammation. If the pterygium is large enough to threaten sight, it is a cosmetic problem, or grows rapidly, it can be removed surgically.

The best way to avoid recurrence is proper surgical removal and conjuntiva´s stem cells graft. In pterygium surgery, the abnormal tissue is removed from the cornea and sclera (white of the eye). Over the years, pterygium surgery has evolved significantly, and modern pterygium surgery has a significantly higher success rate than conventional surgery. In traditional “bare sclera” pterygium removal, the underlying white of the eye (sclera) is left exposed.

Healing occurs over two to four weeks with mild to moderate discomfort. Unfortunately, the pterygium may grow back in up to 50% of patients. In many cases, the pterygium grows back larger than its original size.

Most cornea specialists today perform pterygium surgery with a conjunctival autograft because of a reduced risk of recurrence. In this technique, the pterygium is removed, and the cornea regains clarity. However, the gap in the mucous membrane (conjunctiva) tissue, where the pterygium was removed, is filled with a transplant of tissue that has been painlessly removed from underneath the upper eyelid. Although the procedure requires more surgical skill than traditional surgery, this “auto-graft” (self-transplant) helps prevent re-growth of the pterygium by filling the space where abnormal tissue would have re-grown.

The autograft is held in place with tiny stitches that may dissolve after a few weeks or can be removed in the surgeon’s office. Stitches on the eye frequently cause discomfort, however, after pterygium/autograft surgery. The desire for a quicker, more painless recovery has led to the development of no-stitch pterygium/autograft surgery.

It is also possible to perform this autologous graft surgery without the use of sutures, securing the graft with a special “glue” of organic origin, which reduces postoperative discomfort, speeds recovery and reduce even more the possibility of recurrence of pterygium.

 

Limbal graft

Limbal graft

Graft 8 days after surgery

Graft 8 days after surgery