3 Topic Commentaries

A Dual Approach for Pterygium Removal

A Dual Approach for Pterygium Removal

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  Matt (Matthew S.) Ward, MD

  Cornea and External Disease

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  University of Iowa Carver College of Medicine, Department of Ophthalmology & Visual Sciences

  Pterygium surgery with conjunctival autograft remains the gold standard for reducing recurrence after its initial description in 1985 (Kenyon KR, Wagoner MD Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium . Ophthalmology1985; 92, 1461-1470). Recurrence rates are consistently reported in the 5-10% range. The technique demonstrated in this video makes use of Tisseel fibrin glue to anchor the graft in the bed.

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  William Charles Caccamise, Sr., MD

  Ophthalmology (Cornea/Anterior Segment)

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  University of Rochester School of Medicine and Dentistry

  At the time of this posting, the technique of John A. Hovanesian, MD would seem to offer encouraging results. He employs a thin autograft of superior limbic conjunctival-corneal tissue containing stem cells. The autograft is glued to the bare sclera at the site of the dissected pterygium. The glue is a fibrin glue - Tisseel.This fibrin glue obviates the use of sutures in placing the autograft.

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  Mary P. Coday, MD

  Ophthalmology

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  Massachusetts Eye and Ear Infirmary, Harvard Medical School

  The removal may take place in a procedure room or operating room setting. The pterygium is carefully dissected away. In ORDER to prevent regrowth of the pterygium, your ophthalmologist may remove some of the surface tissue of the same eye (conjunctiva) and suture it INTO the bed of the excised pterygium. Alternatively, an antimetabolite such as mitomycin may be applied to the site. Postoperatively, your ophthalmologist may recommend some steroid eye drops for several weeks to decrease the inflammation and prevent regrowth of the pterygium.

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