Pterygium Excision Again?

[Richard_Hom]

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Dear Forum,

Should this patient have a fourth procedure done to excise a pterygium? This 62 year woman has had 3 excisions in each eye over the past 20 years with the most recent being 3 years ago. The fellow eye has a similar new pterygium.

Thanks,

 

[mdkurt]

Dear Forum,

Should this patient have a fourth procedure done to excise a pterygium? This 62 year woman has had 3 excisions in each eye over the past 20 years with the most recent being 3 years ago. The fellow eye has a similar new pterygium.

Thanks,

It's hard to say from the history. Were the previous excisions bare sclera or with conjunctiva autograft? Was mitomycin used? Is there histopath available for the last excision? Most importantly, is this causing significant morbidity? If not, leave it alone.

 

[Andrew_Doan]

I agree with the above. The indications for pterygium excision is high astigmatism, tear surface problems, or obscuration of the visual axis. If she has none of these, then observe it.