Medical Article

การผ่าตัดต้อเนื้อ (Pterygium Surgery) คืนความชัดใสให้ดวงตา มองเห็นได้อย่างมั่นใจอีกครั้ง

Pterygium (Pterygium) is a white cloudy tissue that forms on the conjunctiva of the eye and gradually spreads onto the cornea. It appears like a small wing or triangle creeping towards the center of the pupil. If left untreated, it can cause red eyes, irritation, and in some cases, directly affect vision. One of the most effective treatments is “pterygium surgery,” which permanently removes the abnormal tissue and reduces the risk of recurrence. 
 
<h2>Causes of Pterygium </h2>
 Pterygium is caused by prolonged irritation of the conjunctiva, with the main risk factors as follows: 
<ul>
<li>Prolonged exposure to sunlight or ultraviolet (UV) radiation </li>
<li>Being in environments with dust, wind, or smoke </li>
<li>People with outdoor activities such as outdoor athletes, golfers, farmers, fishermen, and frequent outdoor drivers </li>
<li>Chronic dry eye condition </li>
<li>Genetics or increasing age </li>
</ul>
The best prevention is to avoid strong sunlight, wear sunglasses, and avoid dust when outdoors. 
 
<h2>Symptoms of Pterygium </h2>
 In the early stage, pterygium may not show clear symptoms, but as it progresses, symptoms may include: 
<ul>
<li>Red eyes, eye irritation, or feeling like there is a foreign body in the eye </li>
<li>Tearing or eye burning when exposed to light </li>
<li>Blurred or distorted vision (especially in the corneal area) </li>
<li>In some cases, it may affect the appearance of the eye </li>
</ul>
If these symptoms persist and do not improve, you should see an ophthalmologist to assess the need for surgery. 
 
<h2>When Should Pterygium Surgery Be Performed? </h2>
Ophthalmologists usually recommend pterygium surgery in the following cases: 
<ol>
<li>Pterygium spreading onto the cornea </li>
<li>Affecting vision, such as causing astigmatism (Astigmatism) </li>
<li>Chronic eye irritation, burning, or discomfort </li>
<li>Desire for surgery for cosmetic reasons or to facilitate contact lens use </li>
<li>Pterygium recurrence after medical treatment </li>
</ol>
 
<h2>Pterygium Surgery Procedure </h2>
Pterygium surgery is an outpatient procedure that takes about 20–40 minutes. The main steps are: 
<ol>
<li>Apply anesthetic eye drops and inject local anesthesia around the conjunctiva </li>
<li>Separate and remove the pterygium tissue from the cornea </li>
<li>Smooth the surface of the conjunctiva </li>
<li>Use the patient’s healthy conjunctival tissue to cover the surgical area (Conjunctival Autograft) </li>
<li>Secure the new conjunctiva with sutures or biological glue (Fibrin Glue) </li>
<li>Cover the eye to prevent infection </li>
</ol>
Modern techniques such as using amniotic membrane (Amniotic Membrane) or Mitomycin C help effectively reduce the chance of recurrence. The Fibrin Glue technology shortens surgery time, eliminates the need for sutures, reduces irritation, and removes the need for suture removal. 
 
<h2>Postoperative Care for Pterygium Surgery </h2>
 Proper postoperative care is important for recovery and preventing recurrence. 
<ul>
<li>Use eye drops as prescribed strictly, usually antibiotics and anti-inflammatory drugs to prevent infection </li>
<li>Avoid rubbing the eyes as it may dislodge the graft or open the wound </li>
<li>Wear sunglasses every time you go out in the sun to protect against UV rays and dust </li>
<li>You can bathe, wash your hair, and wash your face as usual but avoid getting soap, shampoo, or tap water in your eyes </li>
<li>Avoid swimming or applying makeup near the eyes temporarily until the wound heals </li>
<li>Attend all follow-up appointments so the doctor can monitor wound healing and assess the risk of recurrence </li>
</ul>
 Generally, patients may feel mild irritation during the first 1–2 weeks, and the redness gradually subsides within about 1 month. 
 
<h2>Possible Complications </h2>
 Although pterygium surgery is a safe procedure, some complications may occur, such as: 
<ul>
<li>Recurrence of pterygium (Recurrence) </li>
<li>Infection of the wound or graft detachment </li>
<li>Red eyes or temporary blurred vision </li>
<li>Increased intraocular pressure from steroid use </li>
</ul>
&nbsp;
However, if surgery is performed by a specialist and postoperative care is properly managed, these risks are very low. 
 
<h2>Outcomes of Surgery </h2>
 After pterygium surgery, most patients experience significant improvement, such as: 
<ul>
<li>Reduced irritation </li>
<li>Clearer vision </li>
<li>Improved eye appearance </li>
<li>Reduced risk of astigmatism caused by corneal deformation </li>
</ul>
 
<h2>Tips to Prevent Pterygium Recurrence </h2>
<ul>
<li>Wear sunglasses that truly block UV rays every time you go outdoors </li>
<li>Avoid dust, smoke, and strong winds </li>
<li>Use artificial tears to reduce dry eye symptoms </li>
<li>Have regular eye check-ups </li>
</ul>
&nbsp;
 Pterygium surgery is an effective treatment option for those with progressive pterygium or vision impairment. It helps restore clear vision and reduces the risk of future complications. 
 
If you have symptoms of red eyes, irritation, or abnormal tissue spreading onto the cornea, you should promptly consult an ophthalmologist for evaluation and to plan the most appropriate treatment for you. 
 
Assoc. Prof. Dr. Prarthana Hirunpatruang
Ophthalmologist specializing in glaucoma and cataracts

Pterygium surgery is a treatment to remove the invasive tissue on the eye that can interfere with vision and cause irritation. It helps restore clarity to the eye and reduces the chance of recurrence. It also provides advice on proper post-operative care.

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