Day: April 5, 2010

How Can it be Treated?

Los Angeles Lasik and corneal surgeon Dr. Khanna says definitive treatment is achieved only by surgical removal. The pterygia may be removed in a procedure room at the doctor’s office or in an operating room setting. It is up to your eye doctor to determine the best procedure for you. The treatment requires some local anesthetic in the eye and is best done at the time of the pterygium excision to deaden feeling in your eye’s surface. Conjunctival auto-grafting is a surgical technique that is effective and safe procedure for pterygium removal. When the pterygium is removed the tissue that covers the sclera known as the conjunctiva is also extracted, auto-grafting replaces the bare sclera with tissue that is surgically removed from the inside of the patients’ upper eyelid. That “self-tissue” is then transplanted to the bare sclera and is fixated using sutures, tissue adhesive, or glue adhesive. After treatment you should be able to return to work.

Suture-less Painless Pterygium Surgery

Drops or gel are used to numb the eye. The pterygium is then removed. A graft, which is a thin clear membrane like cellophane paper is then glued on. Most patients can go back to work or normal activities the next day.

Adjunctive methods

1) Treatment of dry eyes with artificial tears and punctal occluders
2) Treatment of demodex blepharitis
3) Wearing polarized sunglasses
4) Restasis eye drops

Is There a Possibility of Reoccurrence?
In fact, the recurrence rate is between 3 percent and 40 percent. To prevent re-growth after the pterygium is surgically removed, your eye surgeon may suture or glue a piece of surface eye tissue onto the affected area. This method, called auto-grafting, is very safe and has a low recurrence rate. Even though the use of auto-grafts has resulted in better success rates, it is technically difficult, time consuming. You will be happy to know that Los Angeles LASIK expert Dr. Khanna has performed thousands of such surgeries. Simple excision without auto-grafting carries a high recurrence rate ranging from 24% to 89%. The addition of mitomycin C (MMC) has been reported to be effective in preventing recurrence. However, postoperative application MMC, especially on a bare sclera, may result in devastating complications such as scleral necrosis and infections.

What are the Complications?

1. Decreased Vision and astigmatism: As the pterygium grows it pushes the corneal tissue causing flattening in the horizontal axis. This causes vision problems.
2. Blindness: if the pterygium crosses the dark part of your eye it can interfere with the light reaching the eye. This can lead to blindness.
3. Restriction of eye movement: pterygium can be considered like an elastic string attached to the eye. If this becomes fibrotic the elasticity is lost the pterygium then acts like a restrictive chain interfering with eye movements.
4. Cancer: Pterygium may harbor cancer cells some times. This is more common if it is a younger patient, only one eye has a pterygium (asymmetric), or the pterygium starts growing aggressively. It is recommended to do a biopsy examination on these removed specimens.

Can You Have LASIK ?
Dr. Khanna recommends to first taking care of Pterygium. Removal of the pterygium releases the tension on the cornea and allows it to return back to its normal shape. If LASIK is done first than there is a chance that the pterygium might grow over the flap causing problems, including dissolution of the flap. Also surgical removal becomes difficult, and when the pterygium is removed the number may recur. Then either LASIK, SuperLASIK or presbyopic implants may be implanted.

Does Insurance Cover this Surgery?
Vision Insurances like VSP or MES do not cover such surgeries. We do accept cash or credit cards if you do not have insurance. But there is Good news! Yes if you have medical insurance they will cover the cost of the surgery. Medicare, blue cross, BlueShield etc, will cover medically indicated Pterygium surgery.

When to Contact a Medical Professional
A person with pterygium should be seen by an ophthalmologist annually, so that the advancement of the pterygium can be recognized, especially before the pupillary zone becomes involved.

Call for an appointment with your ophthalmologist if you have had a pterygium in the past and symptoms recur.