What is Pterygium Excision

Pterygium excision is surgery to remove a pterygium, which is a noncancerous (benign) fleshy growth on the front surface of the eye.

A pterygium starts on the clear outer tissue of the eye (conjunctiva) and expands onto the clear tissue (cornea) that covers the colored part of the eye (iris).

In severe cases, the pterygium may get large enough that it covers the black center of the eye (pupil).

You may need this surgery if you have a pterygium that causes discomfort or affects your vision, and other treatments are not working. You may also choose to have this surgery to improve the appearance of your eye (cosmetic surgery).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had, including eye surgery such as PRK (photorefractive keratectomy) or LASIK (laser-assisted in situ keratomileusis).
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• The pterygium coming back after surgery.
• Eye pain.
• Vision changes, such as blurry vision due to changes in the shape of the eye (astigmatism).
• A feeling like there is something in your eye.
• Scarring on the eye (granuloma).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given a medicine to numb your eye (local anesthetic). You may also be given a medicine to help you relax (sedative).
• A device (eyelid speculum) will be placed to hold your eyelids open.
• The pterygium will be lifted away and removed from your eye.
• A piece of eye tissue (graft) may be attached to the surface of your eye where the pterygium was removed. This graft may be taken from the conjunctiva in a different area of your eyeball.
• The graft may be held in place with small stitches that will dissolve over time (absorbable sutures) or with a type of glue, or both.
• Your eye will be closed and covered with an eye patch.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be given pain medicine as needed.
• You will need to wear your eye patch as told by your health care provider.
• Do not drive until your health care provider approves.

Summary

• A pterygium is a noncancerous (benign) fleshy growth on the front surface of the eye.
• You may need this surgery if you have a pterygium that causes discomfort or affects your vision.
• After surgery, your eye will be covered with an eye patch. Wear it as told by your health care provider.

Pterygium Excision, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Eye discomfort or pain.
• Watering eye (tearing).
• Redness.
• Eyelid swelling.
• A feeling like there is something in the eye.

Follow these instructions at home:

Eye care

• Wear your eye shield as told by your health care provider. Do not remove it until your health care provider tells you to do that.
• Do not rub your eye, even after your eye shield is off.
• Use eye drops or eye ointment as told by your health care provider.
• To prevent your pterygium from coming back:
  • Wear wrap-around sunglasses to protect your eyes from the sun. These types of sunglasses protect not only the front but also the sides of your eyes from sunlight.
  • Wear eyeglasses to protect your eyes from windy and dusty conditions.
  • Use lubricating eye drops in dry conditions.

Activity

• For the first few days after surgery, avoid activities that require a lot of energy (strenuous activities) as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery until your health care provider says that it is safe.
• Do not take baths, swim, or use a hot tub until your health care provider approves. You may shower as usual.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have pain that does not get better with medicine.
• You have a gritty feeling in your eye or a feeling like something is in your eye, and this does not go away after one week.
• Your vision seems to be changing over time.

Get help right away if:

• You have eye pain that gets worse.
• Your eye becomes more red and swollen.
• You have a sudden change in your vision.
• You have pus coming from your eye.

Summary

• After the procedure, it is common to have eye discomfort, tearing, and a feeling like there is something in your eye.
• Wear your eye shield as told by your health care provider.
• Do not take baths, swim, or use a hot tub until your health care provider approves.