Typical histologic features of Pterygium: In the advancing head of thepterygium, conjunctival-like epithelium merges abruptly with corneal epithelium. The underlying bowman’s layer is fragmented and precedes a fibrovascular stroma(asterisc)
• < 1% recurrence rate (Unpublished)
• 1-2 % Dellen
• Cornea limbal scarring
• Sub-graft hematoma>>fenestration
• One corneal ulcer in close to 10000 pterygia
• 2 Upside down grafts (One necrosed, one
Patient KG, after 4
pterygiectomies in Florida.
Pterygium Study (2002-
• 500 Pterygiae (390 Patients)
• Same surgeon (JAM) in all cases
• Average f/u period: 8.9 mo
• Low Recurrence Rate (2.16%) in High Risk
• Higher Temporal Recurrence (4%)
• EVERYONE “CLAIMS” LOW RECURRENCE
• Published recurrence rates decreasing
• Most recurrences are unexpected (Risk Factors?)
• A genetic “recurrence” profile may help predict
who may reccur.
• Management would be modified. (i.e. MMC)
Pterygium Research at
• What is our current recurrent rate?
• Does AMT on donor site decrease healing time?
• Does AMT on donor site increase PTOSIS
• What happens to goblet cells in donor/host sites
• What is the effect of surgery on the endothelium?
Pterygium research at VO
• Data collected in 90+ patients include:
• PREOP: Full exam, pentacam, ant seg OCT,
ECC, Osmolarity, external photos, Impression
• INTRAOP: Video recording, Surgical time,
speculum separation, size , bleeding rate
• POSTOP: Blood under graft, graft coverage,
elevation, pain scores, ptosis, healing rate
The 500 pound
gorilla in the room