“Scissorless,” Sutureless Pterygium Surgery

with Conjunctival or Amniotic Membrane Grafting using Glue

Large Pterygium growing over the Cornea and Pupil
(this person is “legally blind” from this Pterygium)

A pterygium (pronounced “ter y gee um”) is small “wing-shaped” fleshy membrane that slowly grows over the cornea. Although it usually grows in the nasal aspect of the eye (closer to the nose), it can grow on the temporal aspect as well, and it is not uncommon to see them cover both sides of the cornea at the same time (“kissing pterygia”).

It is not exactly clear why they develop, but it is understood that there is a genetic component as well as a history of high exposure to sunlight (people who live in equatorial regions of the earth tend to get them more frequently). Pterygia affect millions of people’s eyes and cause chronic irritation, redness, and tearing. In severe cases, they can cause severe astigmatism and even blindness.

Although regular lubrication with artificial tears and the use of vaso-constrictive eye drops (Naphcon or Visine) helps relieve some of the symptoms of pterygia, they never regress spontaneously and require surgery to avoid worsening symptoms and improving vision.

Pterygia can be surgically removed using local anesthesia only. Once removed, is very important to cover the area that used to be involved with either a small piece of the conjunctiva (the thin clear skin that covers our eyeballs) from one’s own eye in order to prevent the pterygium from coming back.

Dr. Soroudi removes the Pterygium entirely WITHOUT using any scissors
(Dr. Soroudi has pioneered this operation without scissors)

A “conjunctival graft” (B) is harvested from the surface of the eye (under the eyelid) and brought over to cover the affected area (A). This is usually performed after the involved area has been cleaned and treated with an anti-fibrotic agent (Mitomycin-C)

Traditionally, the graft (B) is sewn into place using multiple small sutures. These sutures can cause severe inflammation, irritation, and foreign body sensation

Using a Fibrin Sealant obviates the need for any sutures to support the graft (B) in place. This helps expedite the recovery period with minimal redness, bleeding, and discomfort.

A small piece of conjuctiva (the thin clear skin that covers the eye ball) “B” is removed and placed over the area where the old pterygium “A” used to be. Even today, this graft is resected by ophthalmologists using a blade or scissors which make the eye bleed profusely and make the surgery much more difficult and time invasive. Dr. Soroudi has invented a procedure that allows this graft to be removed WITHOUT SCISSORS which makes the eye much more comfortable, the procedure bloodless and the recovery period much more pleasant.

Once removed, Dr. Soroudi applies a small amount of an “anti-fibrotic” medication (Mitomycin-C) to the involved area. This has been shown to really help prevent recurrences in most patients. Some surgeons apply radiation to the operated eye, which causes severe scarring, and cause tremendous problems in case the ptergygium recurs. Dr. Soroudi never uses radiation to treat pterygia, and actively discourages this technique for anyone.

The graft (“B”) is usually taken from the top part of the eye which is covered by the eyelid. Alternatively, a processed Amniotic Membrane Graft can be utilized to cover the defect, which minimizes the amount of dissection and obviously, post-operative discomfort. There are lots of pros and cons to using Amniotic Membrane Grafts: contrary to common belief, although much more expensive, they are NOT always the best choice for every patient, and you should discuss your options with Dr. Soroudi carefully prior to your procedure.

Most surgeons use sutures to keep these membranes in place which can cause severe irritation and redness during the post-operative period. Instead of sutures, Dr. Soroudi utilizes Tisseel Fibrin Sealant, which is a special glue that helps keeps the grafts in place beautifully without any post-operative pain, redness, or irritation, making the recovery period very pleasant for his patients.

Dr. Soroudi specializes in operating on pterygia that have previously been removed (up to seven times!), with such severe scarring as to limit the eye’s movement and causing double-vision. Having realized over a thousand advanced Pterygium operations, he is one of the most experienced Conjunctival Surgeons in the country. He will discuss your options with you in great detail during your consulation.

Before Surgery (surgery was done on both sides of the right eye and the left (nasal) side of the left eye). This patient had already been operated on TWICE by other surgeons and his Pterygium recurred for the third time.

After Surgery by Dr. Soroudi (surgery done on both sides of the right eye and the left (nasal) side of the left eye).