For most people, the decision to have pterygium surgery isn’t the hard part. It’s the not knowing what happens next that keeps them stalling.
Surgery on your eye sounds confronting. That’s completely understandable. But the gap between what people imagine and what the experience actually involves is usually significant — and almost always in the patient’s favour. So here’s exactly what to expect, from the day you book through to the morning after.
Before the day: what to organise
Once surgery is scheduled, you’ll receive specific pre-operative instructions from Dr Pappalardo’s rooms. In general terms, you’ll need to arrange someone to drive you home — you won’t be able to drive yourself — and you’ll need to avoid eating or drinking for a period beforehand. Any regular eye drops or medications will need to be discussed with your surgeon in advance.
The procedure itself is performed as day surgery. You won’t be admitted to hospital overnight.
On the day: what happens when you arrive
You’ll check in, and nursing staff will prepare you for the procedure. Eye drops and anaesthetic will be administered, and a dedicated anaesthetist will be present throughout to ensure your comfort — this is a proper day surgery environment, not a clinic procedure room.
Pterygium surgery at this level is performed under either a local eye block with sedation, or a general anaesthetic. Which approach is right for you will be discussed with Dr Pappalardo before the day, and the anaesthetist will guide you through what to expect. If you have any anxiety about anaesthesia, raise it early — there’s a good reason a dedicated specialist is involved, and your comfort is a genuine priority, not an afterthought.
The procedure takes between one and one and a half hours. That’s longer than people often expect, and it’s worth planning your day accordingly — both you and whoever is driving you home.
During surgery: what actually occurs
Dr Pappalardo performs the P.E.R.F.E.C.T. for PTERYGIUM® technique — Pterygium Extended Removal Followed by Extended Conjunctival Transplant — developed by Professor Laurence Hirst, one of the world’s leading pterygium surgeons and the researcher behind some of the most significant advances in pterygium treatment over the past three decades.
Once the anaesthetic has taken effect, you won’t feel pain. If you are under sedation rather than general anaesthetic, it is possible for you to be aware of some pressure or movement, but discomfort is minimal for the vast majority of patients.
The pterygium is removed, and the area is reconstructed using an extended graft of healthy conjunctival tissue taken from another part of your own eye. The size and precision of this graft is what distinguishes P.E.R.F.E.C.T. from standard pterygium excision — and the results reflect it. The recurrence rate with this technique is pproximately 1 in 1,000. To put that in context, recurrence rates with conventional approaches typically sit between 10 and 15 per cent.
The cosmetic outcome is equally striking. Most patients find that within weeks of recovery, people around them — colleagues, friends, family — cannot tell which eye was operated on. Many patients themselves forget after time.
Immediately after: the first few hours
Once the procedure is complete, your eye will be dressed with an eye pad and shield, and you’ll rest briefly before being discharged. Your driver will take you home. Plan to rest for the remainder of the day — this isn’t the afternoon or evening to have commitments.
Some discomfort, watering, and light sensitivity in the first 24 hours is entirely normal. You’ll be given post-operative eye drops and clear instructions on how to use them. Following this regime carefully is one of the most important things you can do for your recovery.
What the day after looks like
Most patients are genuinely surprised by how manageable the day after surgery is. The eye will look red — sometimes quite dramatically so — but this is normal and resolves over the following weeks. You’ll have a follow-up appointment scheduled with Dr Pappalardo to check the graft and monitor healing.
The full recovery picture — including when you can drive, return to work, and get back in the pool — is covered in detail in our recovery post. But for most patients, the honest takeaway from the day of surgery itself is this: it was nowhere near as bad as I thought it was going to be.
Ready to take the next step?
If you’ve been putting off a consultation because you weren’t sure what surgery might involve, hopefully this helps. Ask your GP or optometrist for a referral to Dr Pappalardo — and come to your consultation with every question you have. There are no questions too small.
