Pterygium Removal Surgery: Causes, Symptoms & Treatment

Pterygium Removal

Pterygium surgery is the process where a pterygium lies on the cornea is removed. This mainly arises from the sun exposure, constant scrubbing or exposure to wind, and dryness of the eye. The surgery is usually done if:

• It obstructs vision due to its growth on the facial skin specifically the cornea.
• Causes discomfort or recurrent inflammation
• Is cosmetically concerning

Pterygium Surgery

Pterygium surgery is a minor operation to remove a ‘wing-like’ growth of conjunctiva tissue could extend on the cornea. Surgery is usually recommended when the pterygium:

• Affects or threatens vision
• Causes chronic irritation or inflammation
• Is cosmetically disfiguring
• Recurs or grows rapidly

Types of Pterygium Surgery

Bare Sclera Excision

• Simple excision of the pterygium with the white part of the eye sclera being exposed
• High recurrence rate (30–80%)

Conjunctival Autograft (Preferred Method)

• Following pterygium excision, conjunctival autograft, most probably from the upper part of the eye) is used to cover the area.
• Low recurrence (2–10%)
• Usually choose between applying fibrin glue and suturing to affix the graft.

Amniotic Membrane Transplant

• This approach is used when the continent of autografts is not possible, for example if the area has had previous surgeries.
• Little recurrence rates that make it appropriate in recurrent cases or extensive pterygia.

Adjunctive Therapy with Mitomycin C or 5-Fluorouracil (5-FU)

• Patients given preoperatively, intraoperatively or postoperatively in order to decrease the chances of reformation of fibrosis
• Should be used cautiously due to possible side effects such as deterioration of scleral thickness

Pterygium Treatment

The decision of managing pterygium depends with the size of the lesion and the clinical manifestation as well as the behavior of the lesion. Simple pterygium might not need surgery, yet an extensive or invasive lesion most probably will require surgical treatment.

Non-Surgical Treatment (For Mild Cases)

• Recommended when pterygium is minimal, stable and not exerting influence on the patient’s vision.

Lubricating eye drops and artificial tears 

• They include reduction in dryness, surface irritation and foreign body sensation.
• As for the long-term therapy, it is recommended to use preservative-free artificial tears.

Anti-Inflammatory Drops

• Some of the enabling aggravating symptoms include: Mild Steroid or NSAID eye drops help to reduce redness and swelling.
• It is used in the short-term treatment in order to minimize side effects such as elevation of intraocular pressure.

UV and Dust Protection

• Wear wraparound sunglasses to block UV rays
• Avoid windy or dusty environments

Pterygium Eye Surgery

Pterygium eye surgery is a surgical operation that aims at removing pterygium which is a wing-shaped growth of conjunctival tissue that can grow over the cornea due to exposure to UV light, dusty and dry conditions.

Why Pterygium Surgery Is Done?

Surgery is recommended when:

• It is occupying the more central area together with growing further towards the central part of the cornea and with impact on vision.
• This leads to inflammation, skin rash, or soreness or the skin, eyes, or mucous membrane.
• There's significant cosmetic concern
• It is a recurrent or a giant pterygium

Factors Affecting Pterygium Removal Cost

The cost of pterygium operation depends on a number of factors, which can even differ for different countries, clinics, surgeons, and other peculiarities.

Here's a breakdown:

• Type of Surgical Technique Used
• Surgeon’s Expertise and Reputation
• Geographic Location
• Hospital Type
• Consultations and pre-op tests
• Anaesthesia fees
• Surgical facility charges
• Post-op medications and follow-ups
• Use of adjunctive therapies
• Whether One or Both Eyes Are Treated

Pterygium Surgery Recovery

Day 1–3 Redness, irritation, tearing, foreign body sensation

Week 1–2 Discomfort decreases; vision begins to improve

Week 3–4 Redness fades, graft blends better with eye

Month 2–3 Full healing; minimal chance of recurrence if protected

Pterygium Surgery Procedure

Preoperative Preparation

• Eye examination: Slit-lamp exam, corneal imaging (if needed)
• Risk, Recurrence and Counselling: Before engaging in any operation, the patient should consent to it, and the surgeon must explain the possible risks, the recurrence of certain conditions and any post-operation care to the patient.
• Anaesthesia: Local anaesthetic eye drops or injection; mild sedation in some cases

Surgical Procedure Steps

Step 1: Pterygium Excision

• The pterygium tissue is then lifted and taken out from the corneal and scleral surfaces by the hand of the surgeon carefully.
• Step is taken to avoid trauma to the surrounding healthy tissue of the cornea during the cleaning processes.

Step 2: Graft Preparation

• A conjunctival autograft is obtained from the superior part of the eye which may be located behind the upper eyelid.
• In the instances when autograft cannot be incorporated (for example when the surgery is the second one), an amniotic membrane may be used.

Step 3: Graft Placement

• The pterygium is then trimmed and excised, and the graft is sown over the area.

It is fixed using either:

• Fibrin glue which is more comfortable and has a quicker recovery time than other forms of hemostasis.
• Sutures (absorbable or non-absorbable but may lead to mild irritation)

Step 4: Adjunctive Therapy (if needed)

• The use of Mitomycin C (MMC) on patients in order to reduce the recurrence risk, most especially on cases that are tagged as aggressive or recurrent.

Duration

• It is normally done within a period of 30 to 60 minutes depending on the formulation used and the level of diffusion.

Postoperative Protocol

• Therefore temporary use of eye patch or shield can be worn for some number of hours or overnight.
• Antibiotic with steroid eye drops as prescribed for 2-4 weeks
• Do not rub the eye, or perform activities that require heavy lifting or lifting weights and stay away from direct sun exposure especially during the summer times.
• The follow-ups are usually made at Day 1, Week 1, and on monthly basis

Pterygium Removal Before and After

Before Surgery

Appearance:

• Sore associated with a mass tumor of bright pink fleshy structure originating from the white part of the eye, conjunctiva and protruding onto the space occupied by the cornea.
• May appear triangular or wing-shaped
• Eye may appear to be red in color, looking inflamed, or may seem to be dry.

Symptoms:

• Foreign body sensation
• Chronic redness or inflammation
• Distortion of vision while seeing (if growth extends up to corneal center)
• Cosmetic concern or self-consciousness

Pre-op Care:

• Eye exam with slit-lamp
• Presumably, patients should avoid using contact lenses prior to the surgery.
• Application of drops on the eyes and putting on sunglasses to reduce the irritation.

After Surgery

Immediately After:

• Redness, swelling, and mild irritation
• Lesions in the graft area may appear erythematosus and slightly elevated
• Eye patch or shield for the first day
• Vision may be temporarily blurred

Appearance (1–4 Weeks):

• It fuses with the natural graft tissue after several hours of operation
• Redness gradually subsides    
• The eyes have become clearer and usual sclera transparency is seen.
• Cosmetic improvement is often significant

Long-Term (2–3 Months):

• Eye returns to normal appearance
• Vision typically stabilizes
• No visible growth if the tumor is interpreted to mean that it has not regrown, after treatment.
• This depends with the kind of scarring that would be incurred in the event that the healing process is effective.

Pterygium Surgery Risks

Pterygium surgery is relatively innocuous however they are associated with some risks and probable complications as is the case with most surgical intervention. It is useful to be aware of these to make a good decision and avoid mistaking something related to the post-operation care.

Pterygium surgery complications:

• Recurrence of Pterygium
• Redness and Irritation
• Graft-Related Issues
• Infection
• Corneal Scarring or Thinning
• Double Vision (Diplopia) or Eye Movement Problems
• Allergic Reactions

Pterygium Removal Success Rate

Bare Sclera Excision ~20–70% (high recurrence rate)

Conjunctival Autograft 90–98% success rate (low recurrence: 2–10%)

Amniotic Membrane Graft ~80–90% success (moderate recurrence: 10–25%)

With Mitomycin C (MMC) Often improves success, but risks must be weighed

Pterygium Surgery Outcomes

Pterygium surgery in general yields satisfactory results if the latest method of conjunctival autograft is applied. The following is a brief on the likely outcomes after surgery.

Positive Outcomes:

• Cosmetic Improvement
• Visual Improvement
• Low Recurrence (with advanced techniques)
• Quick Recovery

Why Choose GetWellGo for Pterygium Surgery?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for pterygium surgery.
• Expert ophthalmologist with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food