Category Archives for pterygium

PERFECT Pterygium surgery



Today we are going to discuss a novel technique develope by an Australian Surgeon and adpted by Khanna

What Is pterygium 

A pterygium is a light reddish or pinkish, triangular growth of tissue on the cornea, which is the outer layer of the eye from which light enters the eye. It usually begins on the cornea near the nose. It might also gradually expand to a bigger size, however rarely expands so big that the pupil is covered by the growth. Usually both eyes are included but the reason for this is uncertain.

A pterygium is an elevated or extended, wedged-shaped bump or growth on the eyeball that begins on the white of the eye also known as sclera and then can get into the cornea or the outer layer of the inner circle from which light enters the eye. If someone has more than one of these eye growths, the plural form of the word is pterygia.

Though it's generally called "surfer’s eye," you do not need to be a surfer or ever before have seen the sea to suffer from a pterygium. However being in intense sunshine for lengthy hours-- specifically when you get on water, which reflects the sunlight's harmful UV rays - raises your risk.

Pterygia are benign (non-cancerous) growths, however they can completely damage the eye. They additionally can create pain as well as a fuzzy vision.


Although ultraviolet radiation from sunlight seems the main reason for the growth and also development of pterygia, dirt as well as wind are in some cases linked also, as is completely dry eye illness.

Pterygia generally establishes itself in 30- to 50-year-olds, and also these bumps on the eyeball hardly ever are seen in youngsters. Having light skin as well as light eyes may place you at enhanced risk of getting a pterygium.

Symptoms and signs

Pterygia typically occurs on the side of the eye closer to the nose, yet they can likewise develop on the side closer to the ear and also can affect one eye or both eyes.

Many people with mild surfer's eye or pterygium might not experience signs and symptoms or require treatment. However large or growing pterygia frequently can cause a gritty, itchy or burning sensation or the sensation something is "in" the eye (called a foreign body feeling). Likewise, these pterygia usually end up being inflamed, causing unappealing red eyes.

If a pterygium dramatically gets into the cornea, it can misshape the form of the front surface area of the eye, triggering astigmatism as well as higher-order aberrations that affect vision.

In some cases individuals confuse pterygia with eye growths called pingueculae, however they are different. Find out more regarding what a pinguecula is.

Pterygium Treatment

Treatment of surfer's eye depends upon the size of the pterygium, whether it is growing as well as the signs and symptoms it triggers. Regardless of severity, pterygia needs to be kept track of to avoid scarring that could lead to vision loss.

If a pterygium is tiny, your ophthalmologist might recommend lubes or a light steroid eye drop to lower swelling and also redness. Contact lenses are in some cases utilized to cover the growth, safeguarding it from a few of the effects of dryness or possibly from more UV exposure. Topical cyclosporine additionally might be recommended for completely dry eye.

If pterygium surgical treatment is required, a number of medical methods are available. Your ophthalmologist who carries out the treatment will certainly identify the very best method for your particular requirements.

Pterygium excision may be executed either in a room at the medical professional's workplace or in an operating room. It is essential to keep in mind that pterygium removal can cause or enhance astigmatism, specifically in people who already have astigmatism.

Surgical procedure for pterygium removal normally lasts no more than half an hour, after which you likely will need to put on an eye spot for protection for a day or 2. You ought to have the ability to go back to work or regular activities the next day.


However, pterygia usually return after surgical removal, perhaps because of oxidative stress and anxiety and/or continued UV exposure.

Direct exposure to ultraviolet light from the sun is a presumed cause of pterygia; covered sunglasses will certainly safeguard your eyes from all angles. Some researches reveal recurrence rates are approximately 40 percent, while others have actually reported recurrence rates as low as 5 percent. Some research also shows higher rates of recurrence in those who have had pterygia actually removed during the summer season, possibly due to their increased exposure to sunshine.

So how can we avoid recurrence? And get the best cosmetic outcome? The PERFECT technique

Meticuolous attention to detail is the fundamental hallnmark of this method. The outlines of the pterygium are marked. It is entirely excised. Careful dissection seprates conjunjctiva from the underlying tenons capsule is pulled, cut and removed.

​A conjunct suture or glue a piece of surface eye tissue onto the afflicted area from where the pterygium has been removed. This approach, called autologous conjunctival auto-grafting, has actually been shown to safely as well as effectively minimize the risk of pterygium recurrence.

A medication that can help restrict abnormal tissue growth and also scarring during injury recovery, such as mitomycin C, likewise might be used topically at the time of surgical treatment and/or afterward to decrease the threat of pterygium reappearance. Dr. Khanna has been performing the latest techniques for many years.

After removal of the pterygium, the medical professional will likely also recommend steroid eye drops for a number of weeks to reduce swelling and also protect against regrowth. In addition to using your drops, it's extremely essential to safeguard your eyes from sunlight with UV-blocking sunglasses or photochromic lenses, given that direct exposure to ultraviolet radiation might be a vital factor in pterygium reccurrence.

Recurrent Pterygium Management

Recurrent Pterygium Management.

Measure 10 times and operate once – planning is the key

by Rajesh Khanna MD

*Beverly hills Pterygium expert,

Recurrent Pterygium may be considered a common side effect of pterygium surgery. If the pterygium is removed but no attention is paid to removing the scaffold of tenon’s capsule, nor adjunctt therapies used – there is up to a 70% chance of recurrence. Recurrent Pterygium management is an art and sequence. We end up helping a lot of these patients who had their primary pterygium surgery elsewhere. Pterygium are like weeds. Either behead them, kill them completely or leave them alone. Never prick, sword or irritate them. For then they attack savagely.
Recurrent Pterygium is worse than the original one because they can spread in all directions and have more fibrosis. It means they are more firmly attached to the muscles and surrounding eye tissue. They are also more vascular. The blood vessels supply it the nutrition in its march to conquer territory it had lost before.

Is your Pterygium back again? The above video tells you important information about what you need to know regarding recurrent Pterygium and Pterygium removal.

Before operating on recurrent pterygium:

  • Find out what was done in the original surgical procedure.
  • Treat the dryness of the eye on a war footing.
  • Plan to repeat surgery in winter or when the UV exposure is going to be a minimum.
  • Inject Mitomycin C (avoid in pregnant or breast feeding women) into the Pterygium body. This anticancer drugs kills the cells of the Pterygium including the blood vessel cells. This causes the recurrent Pterygium to shrink in size and its margins to become more defined.
  • The surgery may be more painful so attention should be directed to proper numbing of the eye and even oral or iv pain relievers.

During the procedure of recurrent Pterygium:

  • Identify the borders and extensions of the recurrent pterygium.
  • Identify the muscles like the lateral rectus, medial rectus and the obliques. Avoid trauma to them.
  • If conjunctival autograft does not suffice an allograft may be required.
  • Attention to good control over bleeding is important
  • Avoid using stitches

After surgery for recurrent Pterygium:

  • Close follow up is required.
  • Treat emerging blood vessels aggressively.
  • Taper antiinflammatory drops slowly.

Please don’t worry if you have had a recurrence of Pterygium. If you are out of the Los Angeles area you can skype with us to learn your options. If you send us your insurance card our staff can let you know your insurance coverage.

Above information on Recurrent Pterygium management courtesy of Khanna Vision Institute serving the Thousand Oaks and Los Angeles area,

Pterygium and Lasik eye Surgery

Pterygium and Lasik eye Surgery

Pterygium, which is a callus, is a result of dry eye. Lasik can further increase the dryness of eyes. Hence, Lasik eye surgery may cause progression of Pterygium. Depending on the decision of the surgeon Lasik eye surgery should be avoided in the presence of Pterygium.

There are several reasons why Lasik may be deemed unsafe if you have Pterygium:

  • During the process of making the Lasik flap the head of the Pterygium may get cut. This is a big problem for the patient. For an irritated Pterygium is worse for the eye.
  • Second the Pterygium may go grow into the interface causing visual problems. Since the potential space allows it an unimpeded progress it may expand in all directions lifting the flap. This results in irregular astigmatism causing ghosting of images.
  • Thirdly the progressive Pterygium may grow over the flap. Removing it may be very difficult, as it may lift the flap.
  • Lastly the Pterygium may grow over and under the flap and this will affect the nutrition of the flap leading to the destruction of the edges of the flap.

So what are the options to see better in the presence of Pterygium?

  • Superlasik eye surgery is a great option for people suffering with pterygium. It avoids entering into the cornea. It can avoid disturbing the flap.
  • Another option is Visian ICL: Implantable collamer lenses inserted away from the pterygium
  • The best option is Superlasik eye surgery combined with Pterygium removal. Superlasik as you may recall, uses a highly specialized automated instrument called epikeratome. This separates the top layer of the cornea along a natural cleavage plane. The same plane is required to separate the progressive pterygium.

Therefore combining the two procedures makes a lot of sense. It does require advanced instrumentation and higher skill. But this is likely the best option to tackle two problems at once. Also since both procedures require similar medications it saves time and money for the eye drops. And it will decrease the total number of visits to the lasik eye surgeon.

Rajesh Khanna, MD

Dr. Khanna, of the Khanna Vision Institute, has performed hundreds of vision corrective surgery with patients suffering from pterygium. Located in Beverly Hills and Thousand Oaks, Khanna Vision Institute has helped thousands of individuals achieve the best vision possible after ridding them of pterygium from their eyes.