Pterygium

Advancing Pterygium Treatment with P.E.R.F.E.C.T. for PTERYGIUM®

In the realm of ophthalmology, the quest for an effective and aesthetically pleasing treatment for pterygium has been long-standing.

Over the past 25 years, a significant breakthrough has been achieved through the development of the P.E.R.F.E.C.T. (Pterygium Extended Removal Followed by Extended Conjunctival Transplant) for PTERYGIUM® technique by Professor Hirst.

This innovative approach represents a significant enhancement of the traditional autoconjunctival transplant method, setting a new standard in the treatment of pterygium.

A Leap in Recurrence Reduction: The P.E.R.F.E.C.T. for PTERYGIUM® technique has dramatically shifted the landscape of pterygium surgery outcomes. Traditionally, the recurrence rates of pterygium post-surgery have been reported in the literature to range between 10 to 15%. However, the application of the P.E.R.F.E.C.T. for PTERYGIUM® method has seen this rate plummet to an unprecedented 0.1% (1 in 1000 cases). This monumental reduction in recurrence is a testament to the precision and effectiveness of this technique. 

Cosmetic Excellence: Beyond the technical success in minimizing recurrence, the P.E.R.F.E.C.T. for PTERYGIUM® method excels in delivering exceptional cosmetic results. The surgical outcome is often so seamless that, within a few months, a study found that patients themselves often did not recall which eye underwent the procedure. This level of cosmetic success is significant, allowing many patients to resume their lives without the visual reminder of having had surgery. Casual observers are also typically unable to discern any difference between the treated and untreated eyes, underscoring the technique’s excellence in aesthetic restoration. 

Addressing Recurrent Pterygium: The P.E.R.F.E.C.T. for PTERYGIUM® technique is not limited to first-time cases but is also adept at treating recurrent pterygium—those that have previously been operated on by other methods and have returned. While the procedure for recurrent cases is inherently more complex, requiring between 1½ to 2 hours of operating time, the outcomes remain highly positive. The recurrence rate slightly adjusts to 0.5% (1 in 200 cases) for these more challenging scenarios, and while the cosmetic results may vary, they often still represent a significant improvement. 

A Commitment to Excellence and Patient Care: As a specialist in pterygium surgery, my dedication lies in providing my patients with the most advanced treatment options available. The P.E.R.F.E.C.T. for PTERYGIUM® technique embodies this commitment, offering a solution that not only addresses the functional concern of recurrence but also meets the aesthetic desires of my patients.  

Operation

The P.E.R.F.E.C.T. for Pterygium surgery is a specialized and careful procedure, performed in a clean operating theatre at an accredited day hospital. It takes approximately an hour and is performed with the eye having an anaesthetic to numb, ensure you are comfortable and feel no pain during the surgery. You are also given a sedative to relax. We will check in regularly with you to ensure your comfort. This operation needs a highly skilled team, including an assistant who helps ensure everything goes smoothly.  

Recovery

Post-operative recovery is a crucial phase, starting immediately after the surgery. Patients might initially experience mild to moderate pain, which is a normal part of the healing process. This discomfort typically subsides within a day or two, managed effectively with prescribed pain relief medications. Our audits have found that patients typically require about two panadeine forte tablets on average in the first 24 hours. Whilst the patch is necessary for the first night after surgery, once the patch is removed the next day, the eye is significantly more comfortable.  

Double vision may occur temporarily, especially when looking away from the site of the pterygium. This effect generally diminishes within the first few weeks, gradually improving as the eye heals. It is important that you do not drive, operate machinery, go up ladders, etc during this time – you will need to make alternative arrangements for your safety and others. During this period, patients are also advised on specific care measures, including the importance of keeping the eye clean and where needed, the use of protective eye patches in potentially contaminating environments. 

The recovery regimen includes a series of eye drops to reduce inflammation and promote healing, extending over two months. Follow-up visits are scheduled to monitor the healing process, with the first few weeks being critical for observing any signs of infection or unusual symptoms. 

Risks

The risks associated with P.E.R.F.E.C.T. for Pterygium surgery are minimal but important for patients to understand. Potential complications, although rare, can range from minor issues such as cysts or inflammation to more significant concerns like persistent double vision or drooping eyelids. Each of these scenarios carries a specific incidence rate, underscoring the low likelihood of their occurrence. You will be given an in-depth discussion with myself and the team as well as written information on what to expect to ensure you are able to make a fully informed decision. 

In extremely rare cases, there is a small risk of severe vision loss due to infection or eye perforation. It is important to note that the risk profile may vary slightly for surgeries on recurrent pterygium, with a slightly increased (but still rare) possibility of persistent double vision due to the pre-existing scarring wrapped around the eye muscles that needs to be treated. Such cases may require additional corrective procedures. 

An evaluation for suitable candidacy is important, which is provided at our centres to ensure optimum safety for you. Comprehensive consultations will provide a balanced medical opinion of whether this surgery is a good option for your eye, as not everyone is suited to undergo this procedure. For example, very high prescriptions may not necessarily be ideal candidates for this procedure, but there may be other vision correction options available to you which can be discussed during your consultation.