After Pterygium Removal Surgery

Reverend Francis RitchieMiscellany

Pterygium Removal Surgery

Five days ago I had surgery to remove a Pterygium that had grown to the extent where it was encroaching on my pupil and therefore was affecting my vision. It had grown from the sclera beginning at the corner of my eye, over the cornea, covering one side of the iris of my left eye and was beginning to grow over the edge of the pupil. Because it was beginning to affect my vision I decided to have it removed using a Pterygium removal surgery that involved removing the Pterygium and grafting a piece of sclera from under my upper eyelid to the place where the Pterygium was removed from. This was grafted in place using stitches (sutures). The Pterygium removal surgery was undertaken under local anaesthetic and so I was fully aware of the whole process as it took place. This type of surgery severely limits the chances of Pterygium regrowth.

Day 5 After Pterygium Removal Surgery

Being fully aware of the procedure during the Pterygium removal surgery was a nerve wracking experience. My good eye was covered while my left eye was given a numbing and sterilizing drop, an anaesthetic gel and then injected to completely numb it. I was then aware as tweezers, another needle, scalpel and other objects were used during the surgery – at one point I could smell a faint burning – my guess is that a wound was being sealed to stem bleeding… but that’s just a guess. As the surgeon started to work on getting the graft I stated that I could feel something – some more drops or gel were applied (I can’t remember which) but I could still feel something (only faintly) so the doctor injected that part of my eye. I didn’t feel the injection and from then on I couldn’t feel anything again.

All that said, it was painless. The biggest issue during the surgery was controlling my own apprehension. I was aware of a fit of nervous giggles bubbling just below the surface so I concentrated on my breathing and thoughts in order to stay calm and follow the surgeon’s instructions on where to look. I believe sedation is an option but it’s probably easier for the surgeon to work with the patient fully aware so they’re able to follow instructions on where to look in order to allow for better access to the whole eye as needed.

I’m partly writing this for those who may be undergoing Pterygium removal surgery and want to know what to expect. Being fully aware of what to expect during the recovery period is the most important. I had the surgery that involves stitches. Some surgeons use a glue instead for a faster recovery time. I can’t comment on the recovery process for surgery that uses the glue rather than stitches as my surgeon used stitches.

The surgeon warned me that about an hour after the Pterygium removal, once the anaesthetics had completely worn off, that I would feel like I had gone through surgery (I felt fine immediately following the surgery). That warning came true though it took a couple of hours for it to completely set in. I had been given eye drops to use 4 times per day (1 drop each time) and a box of Panadeine tablets to be taken every four hours. I was given enough for five doses to cover the first couple of days. I don’t want to think what it would have felt like without those because I was in agony with them. The first night was extremely painful and irritating. After calling a pharmacy we added Nurofen to the mix and I was still feeling it.

That first afternoon and the following day I tried to keep my eyes closed as much as possible to limit the movement of the eye that had been operated on as the stitches were new and scratchy and my eye was extremely light sensitive. I would have struggled had my wife not been around to care for me, apply the eye drops, monitor my pain medication and get stuff for me as needed. I was very uncomfortable. My wife has been amazing. She’s a real blessing.

The following couple of days were a mixed bag with the stitches being very aggravating as they sit just under my upper and lower eyelids so not only did I have the pain but I felt as if there was something constantly in my eye and the eye naturally kept watering in order to try and flush out what it would have sensed as a foreign object. I used painkillers consistently to reduce the irritation, so needed more than I was initially given. Slow release Voltaren seemed to work well along with Paracetamol and Codeine occasionally. I still had headaches and felt strained every time I tried to keep my eyes open for an extended period.

Yesterday (day 4 following the Pterygium removal surgery) had been preceded by a sleepless night and it took me half the day to be able to get the affected eye open comfortably. Yesterday was also the first day the graft itself looked properly red. Up until yesterday the sclera that was grafted into place had remained white.

I have used my iPad in bed extensively when I have had my one good eye or both eyes open to give myself a low light (screen brightness set at its lowest) and fixed-focus, limited field of vision distraction. Being able to keep my eyes fixed in one place when they have been open has lessened the movement and therefore the irritation.

Today (day 5) is my first day properly moving around the house, using our main computer and keeping my eye open. I can feel things there but it is the most comfortable it has been. The stitches must have softened. It doesn’t feel like a strain to have it open. I am anticipating hopefully being able to go back to work tomorrow (I work in an office) and I also have a post-op catch up with the surgeon to check my progress. It still gets a bit watery.

If you’re getting the surgery it would pay to be fully aware of what type of Pterygium removal surgery you are having and what type of recovery to expect. Make sure you ask lots of questions to get a realistic expectation of recovery and be fully aware of what options there are for dealing with the pain following the surgery.

I’m happy with the progress now and the fact that there is no growth anymore over my iris and pupil makes it worthwhile even if the recovery takes a while longer. The fact that this sort of surgery can be done and for it to be done under local anesthetic only, amazes me. I’ve been told that the eye will remain red for at least a couple of weeks following the Pterygium removal surgery and full recovery may take months, but, at this point I’m glad I did it.

Update:

A number of people have asked for a follow up photo of my eye. I just had a cold so it’s not the most stunning looking, but it is now December, 6 months on from my surgery almost to the day and my eye was fully healed months ago. This is what it looks like now. I’ve blurred around the eye so you can see the eye very clearly. It’s important to note that the original Pterygium stretched right from the nasal side and was encroaching over the cornea and was beginning to cover the pupil. It has been completely cleared.

Pterygium Removal Surgery

6 months after Pterygium removal surgery.