Orange County, California
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Pterygium No-Stitch Surgery

Harvard Eye Associates is excited to share with you an incredibly successful new autograft technique using tissue "glue" for no-stitch pterygium removal surgery!

Pterygium Eye Specialist Orange County

Best Technique

More Comfortable

Shorter Recovery

Excellent Results!


We literally "wrote the book" on Pterygium.

Published by Slack Books on innovative pterygium removal techniques, written by Dr. Hovanesian of Harvard Eye Associates. Click on book to enlarge image.

Three Harvard Eye Associates Videos about pterygium removal are in the video player below. Watch all in succession or click on the side arrows to find specific videos.

Jamie Chambers - KTLA News Television

Video 1 Above = Reporter Jamie Chambers discusses his no-stitch pterygium removal surgery.

Mickey Munoz - ABC News Television

Video 2 Above = Mickey Munoz and his experience with no-stitch pterygium removal surgery.

William Ford, Executive Chairman - Ford Motor Company

Video 3 Above = William Ford traveled all the way from Michigan to receive his no-stitch pterygium removal surgery.

What is Pterygium?

Pterygium (pronounced "tur-RIDGE-ium") is a benign thickening of the outer coating (conjunctiva) of the eye that grows onto the cornea. As a pterygium grows, it may become red and irritated. Eventually, it may cause visual disturbances by disrupting the normally smooth surface of the cornea. In severe cases, a pterygium can block a patient's vision altogether.

No-stitch pterygium surgery is made possible by the use of modern tissue adhesive*, composed of clotting proteins normally found in human blood. Tissue adhesive allows the surgeon to secure a conjunctival autograft in seconds rather than minutes. After about one week the tissue adhesive dissolves, leaving no residue, and the eye heals comfortably.

BEFORE and AFTER No-Stitch Pterygium Removal

Pterygium Before Surgery Pterygium 1 day after surgery Pterygium 1 day after surgery
  Pterygium Before Surgery 1 Day After Surgery
(eye is normally red at first)
1 Month After Surgery
(eye is healed and beautiful)
Pterygium Before Surgery Pterygium One Month After Surgery Pterygium Six Months After Surgery
  Pterygium Before Surgery 1 Month After Surgery
6 Months After Surgery
Pterygium Before Surgery Pterygium Immediately After Surgery Two Weeks After Surgery
  Pterygium Before Surgery 1 Week After Surgery
2 Weeks After Surgery

Causes of Pterygium

UV radiation (usually from sunlight) is the most common cause of pterygium. This explains why pterygium occurs with increasing frequency in climates approaching the equator. Other causes include continuous exposure to dry, dusty environments. People who spend significant time in water sports (surfing or fishing) are particularly susceptible to pterygium because of the intense exposure to UV that occurs in these environments. When the eye is continuously assaulted by UV rays, the conjunctiva may thicken in a process similar to callus formation on the skin. The sensitive structures of the outer eye often can not comfortably tolerate this degenerative process, and irritation, redness, foreign body sensation, and ocular fatigue can result.

Preventing Pterygium

The best method of preventing pterygium is to regularly wear UV 400 rated sunglasses when outdoors in sunny conditions. Sunglasses with a wrap-around design provide better protection than those with large gaps between the sunglass frame and the skin around the eyes. Wearing a hat with a wide brim provides valuable additional protection.

Treating Pterygium

In mild cases, pterygium redness and discomfort can be controlled with lubricant eye drops (artificial tears). When symptoms of redness, irritation, or blurred vision are resistant to conservative treatment, or when vision is affected by progressive growth of a pterygium, surgery is considered.

History of Pterygium Removal Surgery

In pterygium surgery, the abnormal tissue is removed from the cornea and sclera (white of the eye). Over the years, pterygium surgery has evolved significantly, and modern pterygium surgery has a significantly higher success rate than conventional surgery.

In traditional "bare sclera" pterygium removal, the underlying white of the eye (sclera) is left exposed. Healing occurs over two to four weeks with mild to moderate discomfort. Unfortunately, the pterygium may grow back in up to 50% of patients. In many cases, the pterygium grows back larger than its original size.

Regrowth of Pterygium

Traditional "bare sclera" pterygium surgery has a high rate of re-growth. Occasionally, the pterygium grows back larger than the original.

Over the years, surgeons have used several different techniques to lessen the likelihood of pterygium recurrence, including radiation treatment and the use of "antimetabolite" chemicals that prevent growth of tissue. Each of these techniques has risks that potentially threaten the health of the eye after surgery, including persistent epithelial defects (ulceration in the surface of the eye), and corneal melting.

Conjunctival Autograft with Stitches

Most cornea specialists today perform pterygium surgery with a conjunctival autograft because of a reduced risk of recurrence. In this technique, the pterygium is removed, and the cornea regains clarity. However, the gap in the mucous membrane (conjunctiva) tissue, where the pterygium was removed, is filled with a transplant of tissue that has been painlessly removed from underneath the upper eyelid. Although the procedure requires more surgical skill than traditional surgery, this "auto-graft" (self-transplant) helps prevent re-growth of the pterygium by filling the space where abnormal tissue would have re-grown.

Conjunctival Autograft with Stitches

In conventional autograft surgery, stitches are used to secure the graft in place on the eye. These can cause discomfort for several weeks.

The autograft is held in place with tiny stitches that may dissolve after a few weeks or can be removed in the surgeon's office. Stitches on the eye frequently cause discomfort, however, after pterygium/autograft surgery. The desire for a quicker, more painless recovery has led to the development of no-stitch pterygium/autograft surgery.

No-stitch Pterygium/Autograft Surgery*

No-stitch pterygium/autograft surgery allows most patients to return to work within one or two days of surgery. A research study on 85 patients with pterygium conducted at Harvard Eye Associates has shown that patients undergoing no-stitch surgery had significantly less pain after surgery than those having traditional surgery. The no-stitch technique also reduced surgery time from an average of 21 minutes to 14 minutes. No pterygium recurrences were found in any patients in the study.

Technique for No-stitch Pterygium/Autograft Surgery

Technique for No-stitch Pterygium/Autograft Surgery

In no-stitch surgery, the patient is lightly sedated to ensure comfort, and the eye is completely numbed, so there is no way to see the surgery occurring and no sensation of discomfort. The abnormal corneal tissue is removed and replaced with a thin graft of normal tissue. Over the next 2-3 weeks, the eye gradually returns to a normal appearance.

Magazine, Newspaper and Journal Articles

Orange County Register
A 10-Minute Fix for a 30-Year-Old Eye Problem
After a referral by surfer/friend/optometrist Dr. Bill Peterson, Mickey "the Mongoose" Munoz selected Dr. Edward Kim of Harvard Eye Associates to perform his pterygium surgery.

Ocular Surgery News
Fibrin Adhesive, an Alternative to Sutures in Pterygium Surgery - PDF format PDF
Rapid recovery and patient comfort are two advantages.
Report on no-stitch pterygium surgery by Dr. John Hovanesian of Harvard Eye Associates.
(see Research for further information).

Orange County Register
No-stitch Pterygium Speeds and Simplifies Recovery - PDF format PDF
Biologic glue, rather than stitches, makes healing faster and more comfortable.
Article on no-stitch pterygium surgery by Dr. John Hovanesian of Harvard Eye Associates.
(see Research for further information).

Eye World
No Pterygium Recurrence with Glue - PDF format PDF
Study finds lack of recurrence matches surgical cases that use sutures
Report on no-stitch pterygium study by Dr. John Hovanesian of Harvard Eye Associates.
(see Research for further information).

PBS coverage of pterygium no stitch surgery Orange County

PBS Television Appearance

CLICK HERE for to watch video about pterygium surgery
(4 minutes).

Our Patients Say:

Pterygium testimonial orange county

"I couldn't be happier with my decision to have my pterygium corrected by Dr. Hovanesian!

After years of surfing and kitesurfing daily, the pterygium in my eye was becoming larger and larger, irritating my eye more and more. I would feel it rub against my eyelid and the friction would result in constant eye redness. Besides that, the pterygium made my eye look strange – my eye looked foggy, uneven, and aged. Read more...

Several years ago you removed a pterygium from my right eye ...using stitches. The procedure you used this time did not use stitches; I was amazed that a type of glue would be used instead! What a difference it made for the surgery and my recovery! My husband was shocked at how quickly the procedure went using this new technique - literally a matter of minutes. I never even needed a Tylenol. I just can't get over how fast my eye healed. I can't thank you enough for the thoughtful and thorough attention I received at Harvard Eye Associates. It is evident that you truly care!

Kerry from Australia just writing to say how happy I am with my eyes now. You have made such a difference to the quality of my life. No longer do I have to hide behind sunglasses or be embarrassed to talk to people. My eyes have healed beautifully. I have spoken to so many people on the Internet that suffer from pterygium, and I hope you don't mind, but I have referred them to you, because I know how distressing this condition can be. You are an absolutely beautiful, kind and caring group of people and I wish you all the happiness in the world!

*Fibrin tissue adhesive is a drug approved by the FDA for abdominal surgery. Although its use in eye surgery has not yet been specifically approved by the FDA, continuing research demonstrates that this technique is a safe and effective alternative to eye surgery using stitches. Although tissue adhesive is derived from human blood products, absolutely no cases of blood borne infection have ever been reported among millions of patients treated with this material.

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