May 14, 2015

Pterygium Surgery – The Thorn in Our Side

published on May 14, 2015 by Neel R. Desai, MD, Director Cornea and Refractive Surgery, The Eye Institute of West Florida

As we all know, pterygium surgery can be challenging and is often time-consuming and painful, produces poor cosmetic results, and has high rates of re-occurrence. This can be very frustrating for us as doctors and also for our patients.

Luckily, there is a technique for sutureless pterygium surgery that’s efficient and effective called the TissueTuck™ Technique with AmnioGraft® which utilizes cryopreserved amniotic membrane. I’ve been using this technique for over three years in more than 500 ocular surface cases, and have had a less than 1% recurrence rate. The technique also reduces surgical time and produces excellent and fast cosmetic results with little discomfort.

It’s well understood that inflammation is ultimately the root cause of pterygium growth and recurrence, so before any surgical technique, we must identify and treat the sources of ocular inflammation as described in my article “The TissueTuck Technique: Sutureless Pterygium Surgery with AmnioGraft Reduces Recurrence Rate to Less than 1%.” Once the potential source of inflammation has been treated, the TissueTuck Technique with AmnioGraft can be utilized.

The TissueTuck Technique has four key goals:

  • Minimize surgical trauma
  • Minimize iatrogenic and postoperative inflammation
  • Seal the site of origination of recurrence in the potential space between the resected conjunctiva and Tenon’s fascia (the gap) thereby creating a mechanical barrier
  • Re-create the semi lunar fold

With the TissueTuck Technique, it’s critical to have a tissue graft that can be easily manipulated and tucked into position without tearing, as this sutureless technique requires careful placement of the tissue. Due to this, I recommend the cryopreserved tissue unique to AmnioGraft; it maintains remarkable intraoperative resilience and usability, and also preserves the heavy chain hyaluronic acid / pentraxin 3 (HC-HA/PTX3) biologic signaling matrix which is essential for anti-inflammatory and anti-scarring effects while facilitating the healing process.


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