Pterygium

Some people will develop a reddish, fleshy growth on the nasal side of the white part of the eye.  In some cases, if left unchecked, it can grow across the cornea and harm the vision.  This growth is known as a pterygium (pronounced tur-RIDGE-ium).   It has a "first cousin", a pinguecula, which is in the same position but has a yellowish appearance.  Pingueculas do not grow across the cornea, however, they can be irritating.  There appears to be a relationship between sun exposure and the incidents of pterygiums, i.e., they are seen more frequently in the Caribbean and southern states than in the North.  Individuals who are prone to this problem should wear ultraviolet filtering sunglasses.  South Floridians who spend time on the water, boating and fishing should take special care.

Small pterygia which are not seen to be growing should merely be observed in consultation with an ophthalmologist.  At Miami Eye Center we make a topographical map of the cornea which documents the size for future reference.  Artificial tears are usually prescribed.  In many cases the pterygium will be seen to grow and/or cause difficulty with contact lens wear.  In this instance, surgery is usually recommended.

Treatment Options

The treatment for a pterygium which is actively growing is surgical excision.  This is a brief procedure done with local anesthesia on an outpatient basis in our adjacent surgical facility.  While the surgery itself posses minimal risk to vision, the main difficulty of this surgery is the tendency for the pterygium to re-form.  So as to reduce the possibility of recurrence, we have been using mitomycin C which is an anti-metabolite and suppresses scar formation.  Once the pterygium has been removed, the area is bathed with mitomycin C.   More recently, we have employed amniotic membrane grafts to further enhance the healing process.  These grafts are derived from human placenta.   When secured to the eye in the position of the removed pterygium, it will minimize inflammation, enhance healing and further reduce the rate of recurrence.  Over the two months following the surgery, the graft becomes incorporated into the new tissue that covers the eye in the area where the pterygium had been located.

Pterygium excision with amniotic membrane grafting takes about 30 minutes as an outpatient.  At the conclusion of the surgery, the eye is patched closed for the remainder of the day and night.  The patch is removed the following day and is no longer necessary.  Antibiotic and cortisone eye drops are instilled for the next few weeks to encourage proper healing.

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