Pterygium surgery is a procedure that involves careful removal of this benign overgrowth of tissue from the surface of the eye in order to relieve the discomfort, cosmetic concern or visual disturbance that this tissue is causing.
For those who may be considering this surgery to address their specific needs, it’s natural to have questions about the procedure, recovery, risks, and potential outcomes. Understanding what to expect can help you to feel more prepared and confident in your decision to seek treatment.
1. What is a Pterygium?
A pterygium (“wing of tissue”) is an eye condition whereby there is benign overgrowth of tissue arising from the white of the eye onto the cornea (crystal window of the eye). As this tissue growth extends onto the cornea, it can potentially cause discomfort, irritation, or impact the clarity of vision. A pterygium is also known as “surfer’s eye” because it commonly develops in individuals who spend significant time outdoors exposed to sunlight, wind, and dust—conditions frequently experienced by surfers.
2. When is Pterygium Surgery Recommended?
Pterygium surgery is necessary if the growth progresses rapidly, begins to distort the cornea or threatens clear vision due to extension across the pupil. However, it is also suitable for anyone whose pterygium causes persistent and troublesome discomfort, irritation, redness or cosmetic concerns. Removal prior to the onset of vision disturbance is associated with the best long-term visual outcomes.
3. What Happens during a Consultation for Pterygium Surgery?
Firstly, a consultation for pterygium surgery will involve finding out about how the pterygium is affecting an individual, and any treatments that have been used in the past. This is followed by testing vision and other ocular health parameters. A slit-lamp biomicroscope is used for a detailed evaluation of the pterygium and the ocular surface, and this will include measurements and photographs. The final part of the consultation will involve a discussion around expectations and goals as well as detailed information regarding the surgery.
4. How is the Surgery Performed?
To facilitate the surgery, a fully qualified anaesthetist is involved – they will use sedation (twilight anaesthetic) while performing a numbing injection (block) around the eye and will then ensure ongoing comfort during surgery with either sedation or a full general anaesthetic.
The surgery is then performed, involving meticulous removal of the pterygium tissue and reconstructing that part of the eye using graft tissue (conjunctiva) taken from another part of the eye. This graft helps to achieve excellent healing and prevents recurrence of the pterygium. At the end of the procedure, an eye pad and shield are applied to the eye to keep it rested and protected overnight.
5. Is there Discomfort Associated with the Surgery?
The numbing block given at the time of surgery provides good pain relief for many hours following the surgery. As this slowly wears off later in the day/evening, any discomfort can be managed by taking oral pain relieving medication such as paracetamol or Panadeine Forte (or equivalent). These may be required for a day or two after the surgery. It is common for the eye to feel irritated, gritty, red and sensitive after the surgery and this is expected to continue for around 1-2 weeks. These symptoms can be managed with medicated eye drops as well as lubricant eye drops over this time.
6. What are the Associated Risks and Complications?
All surgical procedures carry risks, however in general pterygium surgery is a safe operation. The main risks include infection, as well as excessive inflammation and delayed healing/settling of the graft. Complications such as significant loss of vision are exceptionally rare. Good communication and follow up are key to identifying any issues that arise in the post-operative period, to ensure an excellent overall outcome.
7. How Long Does the Surgery Take?
The time taken to perform pterygium surgery typically ranges from 60-90 minutes, although in more complicated situations (for example, removal of a recurrent pterygium where there is significant scarring), this can be longer.
8. What is the Recovery Time for the Surgery?
Recovery time can vary from person to person, so only generalisations can be made. Most people will find that they have to limit how much they use their eye during the first week after surgery due to grittiness, irritation and sensitivity. Vision can fluctuate a little and feel blurry over this time. However, at 1-2 weeks post-operatively most have returned to regular work and driving. Swimming and intense exercise will need to be avoided for 4 weeks following the surgery.
9. What Aftercare is Required Following the Surgery?
Comprehensive aftercare instructions are provided on the day following surgery, which is when the first post-operative check is performed. This will include a routine for use of medicated eye drops as well as how to care for the eye. This typically involves wearing an eye shield at night and in the shower for the first 1-2 weeks as well as wearing sunglasses when outdoors. Heavy lifting or strenuous physical activities will need to be avoided during the first 4 weeks. The next routine follow up occurs at 4 weeks, which is an important timepoint to check how the eye is healing following surgery.
10. Can Pterygium Return After Surgery?
Recurrence of a pterygium is possible, however the P.E.R.F.E.C.T. for Pterygium method is associated with a very low (less than 1 in 1000) risk of this. Recurrence can be further prevented by following the post-operative eye drop routine and protecting the eye from UV during the healing stage and thereafter by wearing sunglasses.
11. How Much Does Pterygium Surgery Cost?
The cost of pterygium surgery depends on factors such as the type of pterygium and whether it is recurrent, as these determine the complexity of the surgery and the time taken to complete the surgery. The ophthalmologist’s fee for performing the surgery also includes post-operative follow up appointments – a full quotation for this will be provided after your consultation.
12. Does Medicare Cover the Surgery?
Medicare will provide a rebate for part of the fees payable for both the Ophthalmologist and Anaesthetist, however there will be an out of pocket cost. Medicare does not contribute to the cost of the hospital admission for the surgery.
15. How Should You Prepare for the Surgery?
Certain regular medications such as blood thinners will need to be ceased if possible prior to pterygium surgery. All other regular medications will usually be continued as normal. You will need to fast prior to your surgery, and instructions for this are provided on the day before your surgery. On the day, you should have someone available to pick you up from the hospital and accompany you home.
14. What Results can you Expect from the Surgery?
Typically the expectation is that once recovered from surgery, there is relief from the irritation and discomfort that the pterygium was causing. The surface of the eye where the pterygium was removed will appear whiter and healthier. Vision may improve following pterygium removal, however this is dependent on the nature and size of the pterygium so can not always be guaranteed.
Reasons to Choose Dr Pappalardo for Pterygium Surgery in Brisbane
Dr Juanita Pappalardo, a comprehensive ophthalmologist at Valley Eye Specialists in Fortitude Valley, Brisbane, provides thorough care in the diagnosis and management of pterygium, ensuring patients receive detailed assessments and appropriate treatment options. As the only ophthalmologist in Brisbane accredited as a P.E.R.F.E.C.T. for PTERYGIUM® Partner, she has undergone training under Professor Lawrence Hirst, the pioneer of this surgical technique. Her approach to pterygium diagnosis is thorough, ensuring that each patient’s condition is accurately assessed based on symptoms, the extent of growth, and its impact on vision or cosmetic concerns.
Dr Juanita Pappalardo takes a thorough approach to addressing pterygium surgery questions. During consultations, she provides clear and detailed explanations of the procedure, recovery process, and potential risks, ensuring patients are well-informed about what to expect. By tailoring her approach to each patient’s unique concerns and needs, Dr Pappalardo ensures that all aspects of the treatment process are addressed transparently and comprehensively.
In addition to discussing the surgical technique, Dr Pappalardo guides patients on important factors such as preparation, aftercare, and long-term management of their condition. She also addresses lifestyle or health considerations that may influence recovery or outcomes. This patient-centred approach allows individuals to feel supported and well-prepared for each stage of their care.