What is a Pterygium?

A pterygium is a non-cancerous overgrowth of tissue arising from the white of the eye onto the cornea. Most commonly presenting in young adults and frequently bilateral, the majority (99%) grow from the nasal side of the eye. Exposure to UV light, especially in childhood, is the strongest known risk factor, with approximately 10% of Queenslanders developing a pterygium in their lifetime1.

For some patients, a pterygium will be nothing more than a cosmetic blemish, however, many suffer from recurrent bouts of irritation, redness and inflammation. They can interfere with vision by inducing corneal astigmatism, growing across the visual axis, or causing double vision due to restriction of eye movements1.

Indications for surgical excision include size ≥ 3mm, rapid growth, reduced vision and troublesome ocular irritation symptoms1. Not surprisingly, many patients also dislike the appearance.

Recurrence rates of 15-40% following simple excision are reported1. Recurrent pterygium typically exhibit aggressive growth and are technically far more difficult to remove due to scarring and distorted tissue planes. The cosmetic result following further surgery is often poor.

Pterygium is not a trivial eye disease and a patient’s first operation is their best chance for a permanent solution.

‘P.E.R.F.E.C.T for Pterygium

‘P.E.R.F.E.C.T for Pterygiumis a surgical technique pioneered by Queensland Ophthalmic surgeon and founder of The Australian Pterygium Centre, Professor Lawrence Hirst. In this technique, the abnormal UV-activated tissue, known as ‘Tenon’s layer’, is completely excised, followed by the placement of a very large autoconjunctival graft2.

In his series of 1,000 consecutive surgeries for primary pterygium (the largest single surgeon series ever published), his recurrence rate was 0.1%, which still remains by far the lowest rate ever published. ‘P.E.R.F.E.C.T for Pterygium™’ also results in an outstanding cosmetic result due to the large graft used2.

Pterygium Before P.E.R.F.E.C.T for Pterygium SurgeryPterygium 4 months After Surgery

Prevention is better than cure

Of course, prevention is better than cure and adequate protection from the sun throughout life is key. In particular, young children should be kept out of the midday sun, wear a large-brimmed hat, be wheeled in a stroller with an awning and sunglasses worn from the earliest age possible.

 

Dr Katherine Smallcombe – Ophthalmic Surgeon

Dr Katherine Smallcombe is one of a few surgeons to have completed Fellowship training with Professor Lawrence Hirst and to have become an accredited P.E.R.F.E.C.T for Pterygium Partner.

REFERENCES:
1. Hirst, LW. The Treatment of Pterygium. Survey of Ophthalmology. 2003; 48(2), 145-180.

2. Hirst, LW. Recurrence and Complications after 1000 Surgeries Using Pterygium Extended Removal Followed by Extended Conjunctival Transplant. 2012; 119:2205-2210.