Pterygium Workup

Updated: Nov 28, 2017
  • Author: Jerome P Fisher, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Workup

Imaging Studies

Corneal topography can be very useful in determining the degree of irregular astigmatism induced by an advanced pterygium.

External photography can assist the ophthalmologist in following the progression of the pterygium.

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Procedures

Multiple different procedures have been advocated in the treatment of pterygium. These procedures range from simple excision to sliding flaps of conjunctiva with and without adjunctive external beta radiation therapy and/or use of topical chemotherapeutic agents, such as mitomycin C (MMC). [9, 17]

Using free grafts of conjunctiva (with or without limbal tissue) at the same time as primary excision of the lesion has been widely advocated as the preferred treatment modality for aggressive pterygia. For moderate-to-severe pterygia, some corneal surgeons use amniotic membrane transplants. Both the conjunctival autografts and the amniotic membrane transplants may be sutured onto adjacent conjunctiva and subjacent cornea. Some corneal surgeons seal the graft tissue onto the underlying sclera with the aid of fibrin tissue glue rather than with sutures. [18, 19, 20, 21, 12, 22]

A study by Kheirkhah et al found that conjunctival inflammation was much more common with amniotic membrane transplantation than with conjunctival autograft after pterygium surgery. However, with control of such inflammation and intraoperative application of mitomycin C, both techniques brought about similar final outcomes. [23]

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