A pterygium is a fleshy growth on the whites of the eyes. It is due to the abnormal proliferation of conjunctival tissue, which is the clear layer normally covering the whites of the eyes. It is more commonly seen in people who spend a lot of time in the sun or live in tropical climates. Because a pterygium is elevated, it can cause irritation and become red.
Topical eye drops may be used to help with the inflammation, but if the pterygium is large enough or if it is growing in size, surgical excision may be warranted.
One of the difficulties with pterygium excision is that the pterygium may return up to 50% of the time. If it does return, it may become more aggressive, with more redness, irritation and increased size.
There are several methods that could be used to decrease the risk for recurrence following an excision. These include the use of irradiation, antimetabolites such as Mitomycin C, or conjunctival autografting.
Pterygiums and their management are one of Dr. Yang’s interests. Of the three options above to prevent recurrences, Dr. Yang prefers the use of conjunctival autografting. The main advantage of using conjunctival autografting is that the recurrence rate decreases to about 5%. In this method, once the pterygium is excised, the defect that the pterygium leaves behind is covered by a piece of healthy conjunctiva. This conjunctiva is harvested from a site away from the pterygium, but on the same eye. The harvest site heals quickly over a few days. The conjunctival graft is traditionally held in place with fine, sutures which are usually removed after a week, but Dr. Yang prefers to use Tisseel glue to hold the graft. This results in faster healing and improved comfort following surgery.