After removal of the pterygium. Is pterygium of the eye malignant: causes, symptoms and treatment of education. The use of folk remedies

Pterygoid hymen (pterygium) is a disease of the conjunctiva. The conjunctiva (the mucous membrane of the eyeball) changes, thickens and grows on the cornea from the nasal or temporal side. In this case, the cornea suffers, it becomes cloudy, astigmatism occurs. The only method of radical treatment of this disease is the surgical removal of education. There are many types of pterygium surgery. With all methods, there are relapses of the disease. The most effective are those in which a barrier is formed on the path of growth of the affected mucosa on the cornea. Corneal resurfacing with an excimer laser is of great importance.

Even with an ideally performed operation, the following features of the postoperative period are possible:

• 1. Pain within 1-2 days after the operation, especially during the first hours after the operation.
• 2. Clouding of the cornea in the area of ​​the removed pterygium.
• 3. Redness of the eye, thickening, swelling of the mucosa for 1-2 months.
• 4. Periodically, redness of the eye may occur in the future, as well. Your conjunctiva requires constant monitoring.

Before surgery:

• - On the day of surgery, wash your face thoroughly with soap and water in the morning.
• - In the morning on the day of surgery, you can afford a light breakfast.
• - eye drops will need to be purchased at the pharmacy before or after the operation according to this leaflet and (or) written prescription.
• - Bring sunglasses with you.

You need to bring your test results with you:

• - Blood test for Wasserman reaction
• - Blood test for HIV
• - Blood test for HBS antigen, HCV antigen

Fluorography (chest X-ray)

We are waiting for you on the day of the operation ___________20___, at ______ hour _____ minutes

After operation:

• You can go home after receiving all the necessary recommendations.
• For the first 14 days, do not touch your eyes. Avoid contact with raw water, do not wash your hair.
• Use only special drops prescribed by your doctor.
• In order to protect your eyes from the irritating effect of bright light, wind and dust on the street, you must wear sunglasses of any color and with any degree of shading, which must be washed daily with soap and water.
• Avoid carbonated and alcoholic drinks and a large number liquids.
• The stitches are usually removed 5-7 days after the operation.

We remind you that within 30 days postoperative monitoring is carried out at no additional charge. Appeals within a period of 1.5 to 6 months are paid at a discount, after 6 months (from the date of the operation) - for the full cost. The doctor can give you additional recommendations and schedule an examination.

The scheme of instillation of drops after surgery (unless the attending physician has prescribed otherwise):

Drops can be instilled on their own or relatives can do it. After washing your hands with soap, pull down the lower eyelid of the operated eye, drop 2 drops of medicine into the hollow formed between the eyelid and the eye (do not touch the eye with a pipette!). In this case, it is better to look up. The break between the instillation of different drugs is at least 5 minutes. No drops are needed at night.

FLOXAL 2 drops:
- the first 3 days - 5 times a day. (9.00, 13.00, 17.00, 20.00, 23.00)

TOBRADEX (MAXITROL) 2 drops from the 3rd - 5th (on the recommendation of a doctor) day after the operation:
- 1st week 4 times a day. (at 9.10, 13.10, 17.10, 23.10)
- 2nd week 3 times a day. (at 9.10, 17.10, 23.10)
- 3-8 weeks 2 times a day. (at 9.10, 23.10)

KORNEREGEL
- 2 weeks 3 times a day. (at 9.20, 17.20, 23.20)

In cases where urgent consultation is required, help (sudden sharp decrease in vision, redness of the eye, pain, etc.), you should immediately contact us. Outside business hours, you can call 499-250-5090.

For your convenience, we offer a scheme for instillation of drops after surgery by the clock

Pterygium Removal- surgical excision of a whitish film on the conjunctiva of the eye, called pterygium. At small size defect treatment can be carried out conservatively, however, the formation can be radically removed only surgically. Pterygium removal is performed on an outpatient basis under local anesthesia. With the classical method, the operation is the excision of the film and the closure of the defect with healthy tissue of the conjunctiva, which prevents the recurrence of the disease. At laser removal the affected area and the head of the pterygium are cauterized with a laser. After the operation, an antibacterial ointment is applied to the patient's lower eyelid and a sterile napkin is glued over the eye. In most cases, the outcome of the operation is favorable, complications are rare, the recurrence rate is about 3-5%.

Methodology

Currently, there are two main ways to remove pterygium: traditional and laser. Each of them has its own subspecies and features. The classic method is the excision of the formation with a scalpel. After processing the surgical field with an antiseptic solution, an eyelid retractor is applied to the eye. Then local anesthesia is performed by subcutaneous injection of modern fast-acting anesthetics (ultracaine, procaine). Then the film is excised with a scalpel under the control of a microscope, and the defect of the conjunctiva is sutured.

At this stage of the operation, there are two methods that have fundamental differences. At the first pterygium excised and sutured without plastic defect. This option is used with a small amount of education and quite often leads to a relapse of the disease (24-89%). In the second method, the defect is repaired using a graft. At the same time, a conjunctival flap taken from under the upper eyelid is used to cover the resulting wound and apply several sutures. This method is more modern and helps to prevent the recurrence of pterygium (5-15%). At the end of the procedure, an antibacterial ointment is laid, a sterile napkin is glued. The operation lasts 20-35 minutes, depending on the chosen method and the amount of intervention.

To date laser method removal of pterygium is considered the safest, most effective and least traumatic, allowing to reduce the frequency of relapses and complications. In the operating room, as well as in classical method, carry out the processing of the surgical field, impose a blepharoplasty. Then, under the influence of a laser, both the pterygoid defect itself and its head are removed. If necessary, several sutures are placed on the conjunctiva. This operation lasts 15-20 minutes. At the final stage, an antibacterial ointment is applied behind the eyelid and an antiseptic bandage is glued on. The patient is recommended to be under the supervision of the clinic specialists for several hours in order to avoid the development of early postoperative complications. Upon returning home, the eye should remain bandaged until the next day; it is possible to change the aseptic dressing 1-2 times a day.

After pterygium removal

IN postoperative period the patient is prescribed anti-inflammatory, antibacterial treatment for up to 10 days. Eye drops (mitomycin) are also currently used, which reduce the risk of relapses. In the first 14 days after the operation, you can not wet, rub and scratch the operated eye, touch it with your hand. In order to protect your eyes from the irritating effect of bright light, wind and dust on the street, you must wear sunglasses. Stitches (if any) are usually removed 5-7 days after pterygium removal. With a favorable outcome of the operation and the implementation of all the recommendations of the doctor, the patient can start working in 10-14 days.

Complications

Complications after this intervention, subject to medical recommendations, are relatively rare. The most common of them is the recurrence of pterygium, however, modern methods of removing the film (surgery with a laser, suturing the conjunctival flap) can significantly reduce the likelihood of recurrence of the disease. Also, frequent complications include lacrimation, a feeling of "mote" in the eye, soreness, prolonged redness of the eye, infection. Usually, the above symptoms disappear after a few days, after the postoperative wound has healed. Since the pterygium feeds abundantly on the blood vessels, bleeding and hematoma formation is possible, which resolves on its own within 2 weeks. In the first days after surgery, vision may be blurry, but over time (1-2 weeks) it improves, the final correction occurs 4 weeks after removal of the pterygium.

Cost of pterygium removal in Moscow

In the capital, this intervention is carried out in most multidisciplinary and ophthalmological medical centers of the city. The main factor determining the fluctuations in the price of the operation is the choice of methodology. For example, plastic surgery of a defect and the use of a laser double or more increase the cost of the intervention. Also, the prices for the removal of pterygium in Moscow are affected by the volume of the operation, the duration of the manipulations, and the need for an extended preoperative examination. An important role in the cost of the service belongs to the location of the clinic, its level, the modernity of refractory devices, as well as the qualifications of ophthalmologists and microsurgeons.

All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

Pterygium is an ophthalmic disease in which there is an overgrowth of a well-perfused conjunctival fold covering the cornea. Removal of pterygium surgically - main method fight against pathology.

The exact cause of pterygium has not been established, but it is known that it occurs more often in people living in sunny and dusty regions, as well as in those who work on outdoors and the sun. Of no small importance are low or too heat environment, toxins, chemical reagents in atmospheric air. A certain role is played by genetic predisposition, infection with oncogenic viruses, the presence of the "dry eye" syndrome.

Pterygium causes a visible cosmetic defect and is fraught with serious complications. It is a triangle in the inner corner of the eye, which consists of a dystrophic mucosa, which slowly moves from the limbus towards the central part of the cornea.

In the mechanism of the development of pathology, an increase in the activity of cell division in the mucosa, as well as an abundant growth of the vascular network, is of great importance, so the goal of surgical removal is not only to excise the neoplasm, but also to prevent the re-growth of the active tissue.

The thin part of the fold, which grows together with the cornea, is called the head of the pterygium, and the conjunctival fragment, rich in vessels, is its body. A significant area of ​​the pterygium disrupts the refractive function of the cornea, creates a mechanical obstacle in the path of the light beam, which affects vision. Pathology can affect both one eye and both at the same time.

Pterygium can develop for a long time, but in some cases reaches the pupil in a matter of months. Patients usually come to the ophthalmic surgeon already with the second stage of the disease, when the width of the pathological fold reaches 4 mm. Twice as many men asked for help average age- 20-40 years, that is, young able-bodied people have to operate.

Indications, contraindications and preparation for surgery

The reason for the surgical excision of the pterygoid hymen is considered the very presence of pathology, a cosmetic defect created by a fold on the cornea, and especially advanced stages when vision suffers. Pterygium poses an increased risk of secondary inflammation and infection, which is why surgeons prefer to remove it from the patient.

Indications for pterygium removal:

• Diagnosed 2nd or 3rd stage of pathology;
• Rapid progression of first degree pterygium;
• The personal desire of the patient to get rid of the growth of the mucosa, regardless of the characteristics of the course and stage.

Operation contraindicated persons with acute inflammation of the membranes of the eye, in the presence of a herpetic infection in the acute stage. Allergy to local anesthetics and refusal of the operation by the patient himself can become an obstacle.

The pterygoid fold grows from the side of the limbus - the inner part of the eye up to one and a half millimeters wide, in which the mucous membrane and sclera connect and due to which the corneal epithelium grows.

Eliminate the pterygoid fold of the conjunctiva is possible only surgically, conservative treatment does not bring results, however, despite the abundance of surgical techniques, the risk of recurrence is still quite high - up to 40%. Moreover, recurrence is more severe than primary pterygium. There are patients who have numerous relapses, and the number of operations reaches a dozen or more.

In order to somehow prevent the recurrence of pterygium, ophthalmologists supplement traditional surgery with radiation therapy, antimetabolite treatment, transplantation of fragments of their own mucosa or amniotic membrane.

Amniotic flaps help reduce the risk of recurrence, but can cause a severe immune response. Radiation therapy reduces the risk of recurrence of pathology by a factor of three, but is risky for secondary glaucoma, lens opacity, corneal perforation, and softening of the sclera.

Preparation before surgery includes a consultation with an ophthalmologist and a thorough examination, which consists of examination, biomicroscopy, coherence tomography of the eye, determination of visual acuity. The patient passes standard general clinical tests, undergoes tests for HIV, hepatitis, syphilis, blood clotting. An examination by a therapist is required, which excludes possible contraindications from the internal organs.

Before the operation, there are no restrictions on food or fluid intake, however, you will have to exclude any cosmetical tools and perfumery. On the eve you can not drink alcohol, it is better to leave smoking for good. On the morning of the intervention, the face is washed with plain water. It is worth taking sunglasses with you to the clinic, which will be very useful on the way home.

Features of surgery for pterygium

The operation to remove the pterygium does not require hospitalization, it is performed on an outpatient basis and under local anesthesia with special eye drops. It lasts about half an hour, possibly longer, depending on the technique chosen by the surgeon.

Operations for pterygium are carried out in two stages:

1. Separation of growths from the surface of the eye;
2. Excision or displacement of the separated fold and closure of the resulting mucosal defect.

According to the degree of complexity of surgical intervention, all operations for pterygium can be divided into three main types:

• Interventions with the removal of the pterygium.
• Operative movement of the pathological fold.
• Plastic defect of the conjunctiva.

Surgery to remove pterygium - the simplest. Abroad, they are produced with the exposure of the sclera, cutting off the body and head of the formation and leaving the area of ​​the exposed sclera. Regeneration occurs before the mucosa grows to the limbus. The operation would have been good if it were not for the recurrence that develops in 9 out of 10 operated patients.

The so-called closed exposure of the sclera differs from the technique described above in that the wound edges of the conjunctiva are fixed with several sutures. The risk of recurrence is up to 70%.

The second type of operations are pterygium repositioning techniques without cutting it off. The most famous method is according to McReynolds. He gives relatively small percentage recurrence - up to 12.5%. The operation includes several successive stages:

1. Treatment of the skin with ethanol and iodine, instillation of an antiseptic into the conjunctival sac, anesthesia with dicaine drops;
2. Fixation of the eye with an eyelid dilator;
3. Anesthesia of pterygium tissues by injecting novocaine with adrenaline into it (the latter has the necessary vasoconstrictive effect);
4. Capturing the head of the pterygoid fold with tweezers and carefully separating the tissue from the cornea with excision of the main mass of the pterygium;
5. The conjunctival membrane is incised with scissors and separated to the lower fornix of the eyelid;
6. Suture the head of the pterygoid fold and turn it into a pocket of the mucous membrane.

removal of pterygium according to McReynolds

The transplanted mucosal flap should not cover the cornea or leave a strip of open sclera, it is transplanted strictly on the exposed limbus. The operation is completed by washing the conjunctival cavity with an antiseptic, placing tetracycline ointment behind the eyelids and applying a sterile dressing.

The described operation for pterygium is not without drawbacks., the main of which are the so-called corneal syndrome and the inflammatory process, leading to a subsequent recurrence of pterygium. Corneal syndrome occurs in early dates after surgery due to erosion of the mucosa at the time of separation of the pterygoid fold from the cornea. Damage to small nerve fibers, pain syndrome, spasm of muscle fibers of the eyelids underlie the corneal syndrome.

Another drawback of the McReynolds technique is that the limbus and pterygoid fold damaged by surgical incisions are not separated and cannot be regenerated separately. Under such conditions, the healing mucosa is able to grow back into the defect of the cornea and give a relapse.

The proposals of ophthalmic surgeons regarding the prevention of the described complications consist in separating the elements of the eye that have undergone surgical incisions, the use of soft lenses covering the cornea devoid of an epithelial layer.

Third group of operations for the removal of pterygium includes techniques with the removal of the formation and subsequent plastic surgery of the mucous membrane with one's own or donor tissue.

Removal of the pterygium according to Arlt occurs with the excision of the newly formed tissue, a section of the scleral mucosa and the application of several sutures to the wound edges of the mucosa. The disadvantage of the intervention can be considered the removal of a section of the conjunctiva, which can significantly complicate the reoperation in case of relapse, which develops in about a third of the operated patients.

removal of pterygium according to Arlt

After the removal of the pterygium, foreign specialists perform plastic surgery with the patient's own mucous membrane, which is cut out from different parts of the conjunctiva of the eyeball. Attempts are being made to use a femtosecond laser to obtain a mucosal graft. The probability of recurrence is 40%.

Attempts to avoid recurrence have led some surgeons to refuse to use any sutures. They fix the mucous flaps with a special fibrin glue, which not only facilitates the operation and subjective discomfort after treatment, but also gives a lower likelihood of pterygium re-growth compared to suture techniques. The disadvantages of fibrin glue are insufficient fixation and divergence of the edges of the wound, the possibility of cyst formation, pain syndrome.

Surgical research aimed at improving long-term outcomes of treatment continues. There is evidence of the use of extended conjunctival graft transplantation, in which the risk of recurrence is almost zero, but this operation is not yet widely used. It is possible to use the amniotic membrane "Flexamer".

Plasty with your own mucosa or amniotic membrane after removal of the pterygium can lead to complications, including:

• Violation of the sensitivity of the surface tissues of the eyeball;
• Inflammatory process.

It is easy to see that any type of surgical treatment of pterygium is fraught, first of all, with relapse. This is the most common complication faced by ophthalmic surgeons, and its risk depends on the type of operation performed, individual features tissues of the patient, his lifestyle and occupation. Definite value has the skill of a surgeon. According to statistics, the smallest risk of recurrence is given by operations followed by plastic surgery of the mucosal defect with one's own tissues.

Recovery after surgery

After surgery, there is no need to stay in the clinic, so the patient can go home. Better - accompanied by someone close to you. You will not be able to drive. During healing, soreness, pain in the eyes, discomfort during visual stress, and lacrimation may disturb.

In the postoperative period, the patient continues treatment aimed at preventing relapse. Given the mechanisms of pathology development, it is advisable to use radiation and chemotherapy treatment. Radiation therapy gives complications in the form of mucosal ulceration, cataracts, so most specialists tend to chemotherapy as safer and more effective. The patient is prescribed mitomycin C and cyclosporine A.

At home, the operated patient independently cares for the eyes, instills anti-inflammatory, antibacterial and other drugs recommended by the attending physician. If possible, it is worth minimizing the load on the eyes so as not to provoke excessive dryness of the cornea.

The first two weeks should be carefully monitored eye hygiene, exclude the use of any cosmetics and foreign bodies, as well as water. Eyes should not be rubbed, touched with hands. To ensure correct and timely regeneration, it is necessary to avoid being in the bright sun, getting smoke and dust into the eyes.

Recommendations regarding lifestyle, sun exposure, exposure to wind and dust do not only apply to the rehabilitation period. They must be followed at all times. If pterygium often recurs, and this is due to professional activities (hot workshops, dusty production, Agriculture), it makes sense to think about changing jobs for the sake of maintaining eye health.

Video: eye pterygium, surgical removal of pterygium

Video: pterygium in the program “Live great!”

Pterygoid formation is a modified corneal tissue.
The appearance of growths leads to an excess of proteins and fats in the body, excessive exposure to UV rays on the cornea, dust, eye irritation by the wind.

Computer technology has a negative effect on the eyes. Often the cause is heredity.

Treatment

Pterygium is sometimes not a cause for concern. In some patients, the formation spreads to half the eye, affecting the central part of the cornea. Often there is dryness of the membrane and a feeling foreign body In eyes.
An effective method of treatment is radical. Removal of a neoplasm by laser cauterization is a new word in modern ophthalmology.
The operation is quite simple:

• The head of the pterygoid hymen is cauterized with a laser under the control of modern technology;
• The dried area is removed with a surgical instrument;
• Eye damage is minimal.

After the operation, the patient uses eye drops and ointments that prevent the development of the inflammatory process in the operated eye. Pterygium of the eye may reappear after the operation. Relapses are unpleasant.

Sometimes, to achieve a lasting effect, it is necessary to operate on the affected eye more than 2 times.

After surgery, protect your eyes with high quality UV-blocking sunglasses.

Price

Operations in ophthalmological clinics are quite expensive. But, for the sake of maintaining vision and maintaining the quality of life at the same level, it is worth spending money. Laser treatment has good prospects.

The price of the operation to remove the pterygium in clinics depends on whether or not the subsequent autoplasty of the eye membrane is performed (a small piece of the cornea is sutured to the remaining part of the pterygium).
The average cost of removing a build-up on the conjunctiva:

1. With autoplasty - 21.5 thousand rubles;
2. Without autoplasty - 15.0 thousand rubles.

Treatment with folk remedies

It is impossible to achieve a complete cure for pterygium with folk remedies. Do not listen to ignorant people telling stories about how a miracle ointment helped them.

Operation is the only effective way get rid of pimples on eyes.

Growing tissues just can not be left. As long as the growths appear slowly, vision does not deteriorate, you should not touch the pterygium.

Drops - an artificial tear - will help to cope with dryness.

Folk recipes after a mandatory consultation with an ophthalmologist can be used to prevent inflammation and eliminate dry eyes. Be sure to take eye medications.

Recipes

Berries or blueberry juice. Excellent remedy preserving vision.

Carrot and carrot juice. Without carotene (provitamin A), contained in this root crop, it is impossible to maintain clarity of vision.

Chamomile decoction. In a glass of water - a tablespoon of dried flowers. Boil 2 minutes. Rinse eyes with strained broth. A good anti-inflammatory agent.

Tea brew. Rinse your eyes with black tea. Refreshes eyes, relieves fatigue.
Raw beet juice. Daily intake in the morning of 100 g of freshly squeezed juice prevents the development of the disease.

Pterygium is an ugly growth that causes discomfort. Many people do not pay attention to this disease, considering it a cosmetic defect that does not require special treatment. But is it really so?

Pterygium is a disease of the conjunctiva (mucosa) of the eye, in which there is a change in its tissues and growth on the cornea. Such growth most often occurs from the medial (internal) angle of the organ of vision. In most cases, both eyes are affected. Specialists also call pterygium pterygium or pterygoid hymen. Education has a triangular shape, gradually grows towards the pupil.

Pterygium is a wing-shaped formation

In addition to a cosmetic defect, the pterygoid hymen causes discomfort and, as a result, reduces visual acuity.

The disease is more susceptible to the elderly, residents of the northern and southern latitudes, as well as persons whose eyes are constantly exposed to various irritants.

Pterygium: video

Classification of the disease: false and true pterygium

Pterygium is classified according to origin, progression, and clinical development.

There are primary (true) and secondary (false) pterygium. True occurs primarily in older people as a result of exposure to harmful factors on the mucous membrane of the eye. Secondary, which is also called pseudopterygium, develops as a result of cicatricial changes in the conjunctiva due to various injuries, operations, burns, inflammations. False pterygium differs from true pterygium in that it does not progress and can be located anywhere in the eye.

Depending on the tendency to progression, there are:

Clinically, pterygium is divided into five stages, depending on the visual impairment, the depth of ingrowth, and the developed astigmatism.

Why pathology occurs: development factors

The histological prerequisite for the development of pterygium is a single origin of the stratum corneum and conjunctival tissues. Hereditary predisposition plays a significant role in the occurrence of the disease.

The exact causes of pathology, experts can not name. There are factors that provoke the occurrence and progression of pterygium:

The occurrence of pterygium provokes chronic irritation of the eyes with harmful substances.

The constant influence of harmful factors on the eyes provokes inflammation of the conjunctiva, a change in the epithelial layer of the outer shell of the eye and the growth of small blood vessels. Due to increased blood circulation in the ocular membrane, keratocytes of the cornea are activated - cells belonging to fibroblasts ("bricks" of the connective tissue of the body). They cause the proliferation of connective tissue, from which the pterygoid hymen is formed.

Symptoms of pterygium: degrees and stages of the course

At the very beginning, the disease does not manifest itself as any unpleasant symptoms. The first sign of pterygium is clouding of a small area of ​​the edge of the cornea, then a small formation appears in this place, which gradually grows.

With an increase in the hymen of the patient, the feeling of a mote in the eye, enduring discomfort begins to bother. These unpleasant symptoms occur due to irritation of nerve endings on inner surface century. Constant dryness and burning are caused by a violation of the formation of a physiological moisturizing film on the eye. The more the pterygium grows, the worse the symptoms become. When the formation grows on the central part of the cornea, visual acuity decreases. Sometimes the pterygoid hymen becomes inflamed and then there is swelling of the conjunctiva, redness of the sclera, itching and lacrimation.

Eye pterygium stage 3

The pterygium has three parts: body, head and cap. The front flat edge or cap is the top of the hymen, it consists of fibroblasts that germinate and destroy the corneal membrane. Behind the cap is a head with a developed network of small vessels, which fuses tightly with the cornea of ​​the eye. The body of the hymen is the largest mobile part of the pterygium.

The progressive form of the disease is characterized by a thickened head protruding above the surface of the cornea, a developed circulatory network. According to the state of the vessels of the hymen, doctors determine its ability to grow:

In the development of the disease, five clinical stages are distinguished:

Diagnostics of the pterygoid hymen

Diagnosing pterygium to an ophthalmologist is quite simple, since the hymen is well defined visually. Ophthalmoscopy, biomicroscopy using a slit lamp, and keratotopography (scanning the surface of the cornea) are usually performed by a doctor. These examination methods allow the specialist to determine the condition of the fundus, the level of astigmatism caused by the disease, as well as assess the lesion and the degree of fusion of the hymen with the stratum corneum.

Photo gallery: examination of the patient

Ophthalmoscopy - examination of the fundus Biomicroscopy using a slit lamp is used to examine different parts of the eyeball Keratotopography - examination of the surface of the cornea

Differential Diagnosis

Pterygium should be differentiated from such eye diseases:

Treatment of the disease: are folk remedies effective?

The only complete treatment for pterygium is surgery. Medical treatment and even more so, folk remedies cannot completely get rid of the problem.

The use of medicines

Conservative treatment is prescribed to alleviate symptoms and slow the growth of the pterygoid hymen.

The pterygium needs to be measured periodically to determine the rate at which the mass is growing: first every 3 months, then once a year.

To reduce eye irritation, artificial tear preparations are prescribed: drops Oksial, Hypromelose, Defislez, Slezin, Hilo-Komod, Vizin, eye gels - Oftagel, Vidisik, Systein-gel.

For moderate or severe inflammation of the pterygium, weak local steroid preparations are prescribed: fluoromethanol solution, loteprendol solution, Dexamethasone drops. Non-steroidal anti-inflammatory drugs are used: Diclofenac, Nevanak, Broksinak drops.

In some cases, Dexamethasone is prescribed as an injection into the body of the hymen in a double course of 10 injections with a monthly break. As a result, there is a flattening and atrophy of the body of the ptegyrium, a violation of its blood supply. Such therapy is indicated for the treatment of grade 1 disease.

To slow down the growth of the pterygoid hymen, the drug Emoksipin (Lakemox) is used - a synthetic antioxidant. For the same purpose, vitamin preparations are recommended - Choline, Riboflavin with instillation into the eye. These funds, improving metabolic processes in the cornea, slow down the growth of pterygium. Hyaluronidase injections inhibit the development of connective tissue, thereby helping to stop the growth of the hymen. Such therapy is effective only for grades 1–2 of the disease; with severe pterygium severity, it can only serve as an addition to surgical treatment.

Photo gallery: drugs for the symptomatic treatment of pterygium

Vizin is prescribed to eliminate the symptoms of dryness and irritation of the eyes Oxial drops - to moisturize the cornea
Oftagel drops are prescribed to moisturize the cornea of ​​​​the eye Broxinac drops are necessary to relieve inflammation and pain relief Systane ultra drops to eliminate the "dry eye" syndrome Diclofenac eye drops are prescribed to relieve inflammation
Emoxipin is prescribed to slow the growth of pterygium
Dexamethasone in eye drops has an anti-inflammatory effect

Surgical treatment: methods for removing pterygium

Surgical treatment is carried out both for cosmetic purposes and if necessary, if the overgrown hymen has reached the optical area of ​​the cornea, due to which vision is steadily declining, and the patient experiences severe discomfort.

Contraindications to the operation to remove the pterygoid hymen:

Modern surgical ophthalmology can offer many techniques for the removal of pterygium. All of them are aimed at excising education. However, pterygium is prone to recurrence, and more aggressive than the primary case, so the usual removal of tissue is ineffective.

Surgery to remove pterygium using layered barrier keratoplasty

Often used is the technique of excising the pterygium tissue, followed by closing the site of the pterygoid hymen with a conjunctival autograft (a section of healthy conjunctiva removed from under the upper eyelid) or an amniotic membrane. To fix the material on the wound, sutures or a special biological glue are used.

Surgery to remove pterygium using an autograft

There is an interesting technique for preventing the recurrence of petrigium. The hymen is excised, a special film is applied to the “bare” area of ​​the sclera, which contains Mitomycin-s (antitumor antibiotic) or 5-Fluorouracil (antimetabolite), it is fixed, and the rest of the wound is closed with a healthy conjunctiva. The film is removed one week after the operation. This method allows not only to avoid relapses, but also gives a good cosmetic effect due to the complete epithelialization of the wound.

Applications of 20% ethanol are also applied to the body of the pterygium before removal and to the sclera after excision. This method is comparable in efficiency with the use of Mitomycin, and the healing of the cornea is even faster.

The operation itself is performed on an outpatient basis, under local anesthesia and lasts about half an hour. The patient can return home 2 hours after the procedure. The duration of sick leave is determined individually.

Surgery to remove pterygium with conjunctival plasty with Alloplant: video

Postoperative period: precautions

After the intervention, the patient is put on an eye patch, which must be worn until the next day and can be changed as it gets dirty. After its removal, it is necessary to instill into the operated eye the medicines prescribed by the doctor according to a certain scheme. Prescribe anti-inflammatory, antibacterial agents and antimetabolites:

The total duration of postoperative therapy is about 30 days.

Do not wet the operated eye for a week. It is recommended to wear glasses with protective UV filters for two weeks after the intervention. For the same period, physical activity is prohibited.

After surgery, the patient, as a rule, is concerned about visual impairment. If the procedure was successful, this function is restored within 5-7 days, sometimes this period lasts a month.

In addition to visual impairment, the patient has a corneal syndrome after surgery:

Possible bleeding from the conjunctiva (immediately after surgery), swelling of the operated eye, redness of the eyeball (passes in 1-2 weeks).

After 7 days, the doctor conducts a follow-up examination, you can start working 10-14 days after the operation.

After the operation, it is necessary to bury the eyes with the means prescribed by the doctor according to a certain scheme.

In addition to the traditional operation to remove pterygium, doctors use laser treatment. With its help, the head of the pterygoid hymen is cauterized. This method is characterized by low trauma and greater safety for the patient's eye. The recovery period after laser surgery is shorter, and there are fewer complications.

Treatment prognosis and complications

The most common complications of progressive pterygium can be:

Less common conditions are:

Therefore, it is necessary to remove the pterygoid hymen.

Possible complications after surgery:

Of the long-term complications after the use of cytostatics or radiation therapy, thinning or ectasia (protrusion of the area) of the cornea or sclera may occur.

Prevention of pathology: how to prevent relapse

Modern techniques allow to reduce the frequency of relapses after surgical removal of the pterygoid hymen to a minimum:

General prevention of the disease: