Changing trends in pterygium management

Abstract

Pterygia are progressive unilateral or bilateral ocular surface growths that develop within palpebral aperture area that leads to contour disruption with symptoms ranging from foreign body sensation to cosmetic blemish. Commonly, they appear during the active period of human life, generally between third and fourth decade. Fate of pterygium spans from progressive growth in its earlier stages that undergo diversity of changes such as inflammation, infection, and degeneration ultimately ending in regressive stage during the sixth to eighth decade of life. Pterygium recurrence is the main complication encountered by surgically treating it with or without adjuvant. Not uncommonly pterygium occurrence had been described during childhood that resolved by conservative treatment. Untreated pterygia might grow exuberantly with the invasion of corneal layers, which might result in significant visual loss due to visual axis obstruction and high astigmatism. Therefore, it is justifiable to treat pterygia at any clinical stage of presentation to prevent ocular morbidity and recurrences. Common misbelief in letting the pterygia until corneal encroachment develops should be made understandable to public by conducting awareness programs. Primary objectives of the present review article are to search for the most successful method in terms of nil to low recurrence rates by various modality of treatment and to arrive at promising surgical technique that provided maximum relief in terms of survival rates on the basis of follow-up duration. Secondary objectives are related to intra- and post-operative complications, which have an effect on the ocular surface and final visual gain or loss.