Pterygium Surgery

While Pterygium initially has a slightly vascular structure, it attaches to the cornea layer and causes astigmatism by causing the cornea to recede in the process as it continues to progress. Blurring of vision begins with astigmatism. In the stages that it progresses to the pupil, it closes the visual axis and causes permanent visual defects.

Symptoms of the disease in the initial phase of the disease cause complaints such as burning, stinging and eye redness

Surgery is the only permanent method for treatment. After the surgery, extra precautions should be taken to prevent the problem from recurring.

What is Pterygium?

The word pterygium means “little wing” in Greek. It is formed when the vessels and connective tissue of the membranous layer called the conjunctiva, which covers the sclera, the white layer of the eye, become abnormally thick and enlarged, and advance on the cornea, the outermost layer of the eye.

This progressive tissue is called fibroblastic tissue. As soon as this tissue progresses, it disrupts the aesthetic structure of the eye on the one hand, and causes visual impairment on the other. It usually occurs on the inside of the eye, close to the nose.

Pterygium can be seen in both eyes. However, it is not a contagious disease. It can lead to permanent vision loss if not surgically intervened.

What Are the Symptoms of Pterygium?

The most obvious of the symptoms of pterygium is the tissue that appears in the inner part of the eye, along with problems such as itching and stinging. The disease starts in the white part of the front surface of the eye and progresses to the cornea layer if not intervened. In the progression of fibroblastic tissue, which can cause astigmatism over time, the problem of visual deterioration also arises. Apart from these symptoms, the following symptoms are also experienced:

If the patient wears glasses, the glasses grades change frequently,
Difficulty looking into the light
Redness of the eyes after bathing

What Causes Pterygium?

Although the cause of pterygium disease is not known exactly, genetic transmission is the first cause of the disease.

The rays coming into our eyes are collected in the area of our eye close to the nose due to the structure of the lid and cornea. As a result of sunlight coming to this area, limbal stem cell death caused by ultraviolet rays begins. When the stem cells begin to deteriorate in the limbus, which is located between the membrane we call the cornea and the conjunctiva, the conjunctiva comes into play and sticks to the corneal tissue by jumping over the dead cells.

It can be seen more in people who have long-term dry eye as a result of being in dusty, dry and hot environments, that is, working outdoors.

The disease can also be encountered frequently in people with chronic eyelash inflammation and dry eye. In addition, pterygium is more common in men. People with allergic eye diseases are also in the risk group.

How Is Pterygium Treatment?

Various treatment methods are available to stop and permanently prevent the progression of pterygium. Drop therapy is the main treatment method used for pterygium progression. Drop therapy is used to prevent dry eyes, to take measures in this regard, to slow down the progression of the disease and to correct inflammation that may occur on the surface.

Although all these are preventive treatments, pterygium surgery is the only permanent treatment of the disease. The pterygium excision and graft application operation is a versatile surgery. With a good surgery, the chance of success varies between 85-100%.

How is Pterygium Surgery Performed?

When the fibroblastic tissue formed in pterygium disease grows to a level that threatens the patient’s vision and continues to progress to the cornea and cosmetically disturbs the defect, it is treated with surgery. The most important point in pterygium disease is to eliminate the risk of recurrence of the disease and relapse more aggressively the next time. It is important in treatment to reduce the risk of pterygium recurrence and the possibility of complications, and to ensure a comfortable and fast recovery process after surgery. Pterygium surgery is performed by physicians who are experts in Cornea and Ocular Surface Diseases and have a high level of microsurgery experience.

Ptergium Excision without Graft:

After the eye is anesthetized with local anesthesia, the fibroblastic tissue advancing towards the cornea is cut from where it comes out.

Grafted Pterygium Excision:

Today, grafted pterygium excision is preferred instead of graft-free operation in order to prevent recurrence of the disease and for the comfort of recovery. The process is carried out as follows;

After anesthetizing the eye with the help of drop anesthesia, fibroblastic tissue is cleaned with an average of 30 minutes of surgical intervention. In order to reduce the risk of recurrence of the disease, autograft tissue is taken from the lower part of the lid of the healthy eye and transplanted by grafting.
Autograft tissue from the healthy area is placed seamlessly using tissue adhesives or dissolving sutures. In patients with recurrent pterygium who will undergo surgery for the second or third time, drugs that will reduce the risk of recurrence can be used during surgery.

What are the Post-Surgery Considerations?

Artificial tear drops should be used for up to 6 months to support the treatment,
After the operation, the need for glasses change arises. This change should be made after 1 month,
Eyes should be constantly protected with UV filter glasses in a sharp daylight environment by using sunglasses,
Dusty environments should be avoided as much as possible, and protective glasses should be used when necessary.
Artificial tear drops should be used in dry environments, eye dryness should be prevented.