Pterygium Removal
No-Stitch Pterygium Surgery —
More Comfortable Removal — Shorter Recovery!*
We invite you
to call to have your questions answered or to make an appointment: 480-981-6111.
Pterygium (pronounced "tur-RIDGE-ium")
is a pinkish-yellow, triangular-shaped benign tissue growth starting
from the nasal area of your eye and grows toward the cornea. As
a pterygium grows, it can be varied in its appearance from small
and pink to large and angry red with symptoms of dry eye. Eventually,
it may cause visual disturbances by disrupting the normally smooth
surface of the cornea. In severe cases, a pterygium can block a
patient's vision altogether.
Before Pterygium Removal  After
Pterygium Removal
Dr. Jonathan Kao performs state-of-the-art pterygium removal
surgery and is well known for his "no-stitch" surgical
technique and instrumentation. He performs a complete excision
of this lesion using no stitches during this surgery, and instead
applies a special surgical glue*. This highly specialized method
for pterygium removal has raised the bar in looks and comfort for
patients with pterygium. Patients from all over the country come
to East Valley Ophthalmology for the expertise of Dr. Kao and his
method to remove pterygiums.
Before Pterygium Removal  After
Pterygium Removal
Causes of Pterygium
Pterygia are more common in sunny climates and in the 20-40 age group. Scientists
do not know what causes pterygia to develop. However, since people who have pterygia
usually have spent a significant time outdoors, many doctors believe ultraviolet
(UV) light from the sun may be a factor. In areas where sunlight is strong, wearing
protective eyeglasses, sunglasses, and/or hats with brims are suggested. While
some studies report a higher prevalence of pterygia in men than in women, this
may reflect different rates of exposure to UV light.
Preventing Pterygium
The best method of preventing pterygium is to regularly wear UV
400 rated sunglasses when outdoors in sunny conditions. 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.
Treating Pterygium
In mild cases, pterygium redness and discomfort can be controlled
with lubricant eye drops (artificial tears). When symptoms of redness,
irritation, or blurred vision are resistant to conservative treatment,
or when vision is affected by progressive growth of a pterygium,
surgery is considered.
Pterygium Surgery
History of Pterygium Surgery
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.
Over the years, surgeons have used several different techniques to lessen the likelihood of pterygium recurrence, including radiation treatment and the use of "antimetabolite" chemicals that prevent growth of tissue. Each of these techniques has risks that potentially threaten the health of the eye after surgery, including persistent epithelial defects (ulceration in the surface of the eye), and corneal melting.
Conjunctival Autograft with Stitches
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.
No-stitch Pterygium/Autograft Surgery*
No-stitch pterygium/autograft surgery allows most patients to return to work
within one or two days of surgery. Research studies have shown that patients
undergoing no-stitch surgery had significantly less pain after surgery than
those having traditional surgery. The no-stitch technique also reduced surgery
time by 20-30%. No pterygium recurrences
were found in any patients in the study.
Technique for No-stitch Pterygium/Autograft Surgery
In no-stitch surgery, the patient is lightly sedated to ensure comfort, and the eye is completely numbed, so there is no way to see the surgery occurring and no sensation of discomfort. The abnormal corneal tissue is removed and replaced with a thin graft of normal tissue. Over the next 2-3 weeks, the eye gradually returns to a normal appearance.
No-stitch surgery is made possible by the use of modern tissue adhesive. Composed of clotting proteins normally found in human blood, tissue adhesive allows the surgeon to secure a conjunctival autograft in seconds rather than minutes. After about one week the tissue adhesive dissolves with no residue, leaving the eye to heal comfortably. Although tissue adhesive is derived from human blood products, no cases of blood borne infection have ever been reported among millions of patients treated with this material in heart and lung surgery.
*Fibrin tissue adhesive is a drug approved by the FDA for abdominal surgery. Although its use in eye surgery has not yet been specifically approved by the FDA, our research suggests that this technique is a safe and effective alternative to eye surgery using stitches.
If you would like further information, please call our office at:
480-981-6111
The Best Possible Eye Care
The eye surgeons of East Valley Ophthalmology perform the full scope
of advanced technology diagnostic testing and treatment, as well
as taking the time necessary to provide each patient the personal
education needed to fully understand their condition and get the
best possible outcomes for their patients. If you or a family member
or friend have not had a recent eye examination, please
take a moment to Request an Appointment.
|