Pterygium Surgery Complications

Pterygium Surgery Complications
SYMPTOMS Symptoms vary depending on complication: Recurrence - blurry vision, irritation | Corneal scar - possible blurry vision | Scleral melt - pain
SIGNS Signs vary depending on complication: Recurrence - typical signs of a pterygium (wing-like fibrovascular tissue, etc.) | Corneal scar - scarring due to tissue remodeling from pterygium removal | Scleral melt - thin, necrotic scleral tissue
WORK-UP Thorough history. Slit lamp examination
TREATMENT Pterygium recurrence and corneal scarring can be observed unless vision is threatened | Scleral melt must be treated aggressively: Topical antibiotics | Oral steroids and/or other immunosuppressive agents | Autograft with antimetabolite (MMC or possibly 5-FU)
FOLLOW-UP Pterygium recurrence and corneal scarring are not urgent | Scleral melt must be monitored very closely (daily until demonstrated improvement)
ETIOLOGY Pterygium surgery | Antimetabolite use
NOTES Mitomycin-C and 5-fluorouracil should be used with caution as they may increase the risk of corneal and/or scleral necrosis | Most recurrences following pterygium surgery occur within the first year