From the Guidelines
For pterygium, lubricating eye drops are the primary treatment to relieve irritation and redness, with preservative-free artificial tears like Systane Ultra or Refresh Tears being used 4-6 times daily. When considering treatment options for pterygium, it's essential to prioritize morbidity, mortality, and quality of life as the outcome. In the context of pterygium, the primary goal is to manage symptoms and prevent complications.
Treatment Options
- Preservative-free artificial tears like Systane Ultra or Refresh Tears can be used 4-6 times daily to keep the eye surface moist and reduce inflammation 1.
- For more significant inflammation, prescription steroid eye drops such as fluorometholone 0.1% or loteprednol 0.5% may be used short-term (typically 1-2 weeks) to reduce swelling and discomfort.
- Vasoconstrictors like Visine can temporarily reduce redness but aren't recommended for long-term use.
- Nonsteroidal anti-inflammatory drops like ketorolac may also help manage inflammation.
Important Considerations
- These medications only manage symptoms and don't remove the pterygium.
- The pterygium is a growth of conjunctival tissue onto the cornea, often caused by UV exposure, and while drops can control symptoms, surgical removal is the only definitive treatment if the pterygium grows large enough to affect vision or causes persistent discomfort despite medication.
- New-onset diplopia can occur after pterygium surgery as a result of direct injury to the adjacent medial rectus or florid scarring, including scarring to adjacent plica associated with recurrence, highlighting the importance of careful consideration before proceeding with surgical intervention 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Options for Pterygium
- Pterygium is a bulbar conjunctival fibrovascular growth that can lead to significant visual complications, and its treatment has been developed over the years to reduce recurrence rates 2.
- Surgery is the main treatment for pterygium, with various techniques such as Bare Sclera, Rotational Conjunctival Flap, Limbal Conjunctival Autograft, Amniotic Membrane Graft, and Free Conjunctival Autograft being used for removal 2, 3.
- Auxiliary treatments such as mitomycin C, b-radiation, 5-fluorouracil, topical use of interferons, and Avastin are also effective in reducing the recurrence rate 2.
Role of Eye Drops in Pterygium Treatment
- Loteprednol etabonate ointment has been shown to be a safe and effective component of the perioperative regimen for pterygium, with a lower risk of elevated intraocular pressure compared to other topical ocular steroids 4.
- The use of artificial tears as an adjunctive drug has been found to lower pterygium recurrence after excision, with a significant difference in recurrence rates between the treatment group and the control group 5.
- Topical steroids, such as dexamethasone, may also be used in the treatment of pterygium, although there is no consensus regarding the optimal dose, frequency, and duration of treatment 6.
Surgical Techniques and Adjuvants
- Current evidence supports pterygium excision with conjunctival autograft fixation using fibrin glue, followed by patching until the first postoperative visit 6.
- Surgical adjuvants, such as mitomycin C, 5-fluorouracil, and bevacizumab, may be used to reduce recurrence rates, and postoperative use of artificial tears and topical cyclosporine 0.05% may also be beneficial 6.