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PubMed This is a summary of 22 peer-reviewed journal articles Updated
Ophthalmology

Surgical Treatment Options

At a Glance

Pterygium surgery is considered when the growth threatens vision, causes persistent symptoms or eye-movement problems, or looks suspicious. A conjunctival autograft usually lowers recurrence risk, while an amniotic membrane transplant is an alternative when healthy tissue is limited.

While many pterygia can be managed with eye drops and UV protection, surgery is an elective option to consider when the growth begins to threaten your vision or quality of life. The goal of modern pterygium surgery is not just to remove the growth, but to rebuild the surface of the eye in a way that prevents the tissue from growing back [1][2].

When is it Time for Surgery?

Your ophthalmologist will generally discuss surgery as an option if you meet one or more of the following criteria:

  • Vision Loss: The growth is approaching or covering the pupil (the center of the eye), physically blocking your sight [1].
  • Significant Astigmatism: The pterygium is pulling on the cornea and changing its shape, causing blurriness that cannot be easily fixed with glasses [3][4].
  • Restricted Movement: The growth has become large or thick enough that it physically prevents your eye from moving freely, which can cause double vision [1].
  • Uncontrolled Symptoms: Persistent redness, pain, or a “gritty” feeling that does not respond to conservative treatments like artificial tears [5][6].
  • Suspicious Appearance: If the growth shows atypical features suspicious for Ocular Surface Squamous Neoplasia (OSSN) or melanoma, surgery is needed to remove the tissue with appropriate margins and confirm the diagnosis through a biopsy [7].

The “Gold Standard”: Conjunctival Autograft (CAG)

The most successful surgical technique used today is the Conjunctival Autograft. In this procedure, the surgeon removes the pterygium and then harvests a small piece of healthy “skin” (conjunctiva) from under your upper eyelid [2][8]. This healthy tissue is then moved to the spot where the pterygium was removed and secured in place.

By “paving” the area with healthy tissue, the surgeon creates a barrier that makes it much harder for the pterygium to return [9]. This technique has significantly lower recurrence rates compared to older methods where the area was simply left bare [10].

Alternatives: Amniotic Membrane Transplantation (AMT)

In some cases—such as when the pterygium is very large, when both eyes are being treated, or if a patient has had multiple previous surgeries—there may not be enough healthy conjunctiva available for an autograft [11].

In these situations, surgeons may use an Amniotic Membrane Transplant (AMT). This is a specially processed tissue graft derived from a human placenta [12]. While AMT can help the eye heal and reduce inflammation, research generally shows that it has a higher risk of the pterygium returning compared to a conjunctival autograft [10][13].

Reducing the Risk of Recurrence

Even with expert surgery, a pterygium can sometimes grow back. Surgeons use two main tools to minimize this risk:

  1. Mitomycin C (MMC): This is a powerful medication that inhibits cell growth. During surgery, the doctor may apply a dilute amount of MMC to the eye for a brief period (the specific concentration and exposure time vary by surgeon) before placing the graft [14][15]. While highly effective at stopping recurrence, it must be used cautiously, as it can occasionally cause complications like delayed healing, infection, or thinning of the eye wall (scleral melt) [16][17].
  2. Fibrin Glue vs. Sutures: Traditionally, grafts were held in place with tiny stitches (sutures). However, many modern surgeons now use fibrin glue, a biological adhesive [18].
    • Fibrin Glue: Generally leads to shorter surgery times and less pain during the first few days of recovery [18][19]. However, evidence on recurrence is mixed, and glue carries some risk of the graft shifting or separating (dehiscence).
    • Sutures: While they can be more irritating and scratchy, they are sometimes preferred for complex cases where the graft needs extra security [20][19].

Risks of Surgery

Pterygium surgery is typically an outpatient procedure performed under local anesthesia. Most patients experience some redness and a “scratchy” sensation for a few weeks as the eye heals [21]. Following your surgeon’s instructions for post-operative eye drops and strict UV protection is critical to ensuring the best long-term outcome [22].

Because it is an elective surgery in many cases, it is important to weigh the risks. Potential complications include:

  • Recurrence: The growth may return, sometimes more aggressively.
  • Prolonged Discomfort: Persistent redness, dryness, or surface pain.
  • Graft Issues: Graft displacement, loss, or separation.
  • Infection or delayed surface healing.
  • Scarring: Formation of a granuloma (inflamed nodule), corneal haze, or irregular astigmatism.
  • Lack of Improvement: The possibility that your vision or cosmetic appearance will not improve as expected.

Common questions in this guide

When should I consider surgery for a pterygium?
An ophthalmologist may discuss surgery when the growth approaches or covers the pupil, causes significant astigmatism or blurred vision, limits eye movement, or produces persistent redness, pain, or gritty sensations despite drops. Surgery may also be recommended when the tissue looks unusual and needs removal and biopsy.
What is a conjunctival autograft for pterygium?
After removing the pterygium, the surgeon takes a small piece of healthy surface tissue from under the upper eyelid and places it over the treated area. The graft creates a barrier and generally has a lower recurrence rate than leaving the area bare.
Why might I need an amniotic membrane transplant?
An amniotic membrane transplant may be used when the pterygium is very large, both eyes are being treated, or previous surgeries have left too little healthy conjunctiva for an autograft. It can support healing and reduce inflammation, but the pterygium may be more likely to return than after a conjunctival autograft.
Does Mitomycin C prevent pterygium from coming back?
Mitomycin C is a medication that slows cell growth and may reduce recurrence when used during surgery. It must be applied carefully because it can contribute to delayed healing, infection, or thinning of the eye wall.
Is fibrin glue better than stitches for pterygium surgery?
Fibrin glue can shorten surgery and reduce pain during the first few days, but the graft can shift or separate and evidence about recurrence is mixed. Sutures may feel more irritating, yet they can provide extra security in complex cases. The best choice depends on the graft and your surgeon's plan.
What is recovery like after pterygium surgery?
Pterygium surgery is usually done as an outpatient procedure with local anesthesia. Redness and a scratchy sensation can last for several weeks, and some people may have discomfort, dryness, or light sensitivity. Using prescribed eye drops, protecting your eyes from UV light, and following activity instructions support healing.
Will the removed pterygium tissue be tested in a laboratory?
If the growth has atypical features, the surgeon may remove it with appropriate margins and send it for laboratory examination to confirm the diagnosis. Ask whether your tissue will be examined, especially if the pterygium looked unusual.

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References

References (22)
  1. 1

    Practice Patterns in the Management of Primary Pterygium: A Survey Study.

    Graue-Hernandez EO, Córdoba A, Jimenez-Corona A, et al.

    Cornea 2019; (38(11)):1339-1344 doi:10.1097/ICO.0000000000002091.

    PMID: 31403528
  2. 2

    Surgical Techniques and Adjuvants for the Management of Pterygium.

    Patel ED, Rhee MK

    Eye & contact lens 2022; (48(1)):3-13 doi:10.1097/ICL.0000000000000849.

    PMID: 34686641
  3. 3

    Treatment of Pterygium on the Refractive Errors: A Systematic Review.

    Rad NR

    Korean journal of ophthalmology : KJO 2025; (39(3)):269-287 doi:10.3341/kjo.2025.0003.

    PMID: 40235101
  4. 4

    Assessment of the corneal high-order aberration changes after pterygium surgery.

    Sapkota A, Chaudhary M, Sitaula S, Gautam P

    Therapeutic advances in ophthalmology 2025; (17()):25158414251379155 doi:10.1177/25158414251379155.

    PMID: 41221121
  5. 5

    Improvement in quality of life and ocular surface symptoms after pterygium excision with conjunctival autograft and fibrin glue: a prospective study.

    Alarcón García AD, Burgos-Blasco B, Robles Amor P, et al.

    Archivos de la Sociedad Espanola de Oftalmologia 2026; (101(7)):502598 doi:10.1016/j.oftale.2026.502598.

    PMID: 42190945
  6. 6

    The Role of 20% Ethanol in Enhancing Pterygium Surgery Outcomes: A Clinical Study.

    Mudhol RR, K S

    Cureus 2024; (16(7)):e65830 doi:10.7759/cureus.65830.

    PMID: 39219973
  7. 7

    Pterygium: an update on pathophysiology, clinical features, and management.

    Shahraki T, Arabi A, Feizi S

    Therapeutic advances in ophthalmology 2021; (13()):25158414211020152 doi:10.1177/25158414211020152.

    PMID: 34104871
  8. 8

    Recurrence-free time after pterygium surgery with sutureless conjunctival-limbal vs. conjunctival graft: is there still a role for conjunctival graft alone?

    Lucentini S, Acuti Martellucci C, Rossi L, et al.

    International ophthalmology 2025; (45(1)):385 doi:10.1007/s10792-025-03770-5.

    PMID: 40996538
  9. 9

    Recurrent Pterygium: A Review.

    Ghiasian L, Samavat B, Hadi Y, et al.

    Journal of current ophthalmology 2021; (33(4)):367-378 doi:10.4103/joco.joco_153_20.

    PMID: 35128181
  10. 10

    Conjunctival autograft for pterygium.

    Clearfield E, Muthappan V, Wang X, Kuo IC

    The Cochrane database of systematic reviews 2016; (2()):CD011349 doi:10.1002/14651858.CD011349.pub2.

    PMID: 26867004
  11. 11

    Amniotic membrane transplantation with narrow-strip conjunctival autograft vs conjunctival autograft for recurrent pterygia.

    Barbosa JB, De Farias CC, Hirai FE, Pereira Gomes JÁ

    European journal of ophthalmology 2017; (27(2)):135-140 doi:10.5301/ejo.5000773.

    PMID: 27405284
  12. 12

    Comparison of hyperdry amniotic membrane transplantation and conjunctival autografting for primary pterygium.

    Pan X, Zhang D, Jia Z, et al.

    BMC ophthalmology 2018; (18(1)):119 doi:10.1186/s12886-018-0784-4.

    PMID: 29764389
  13. 13

    [Outcome of pterygium excision after various surgical techniques-is excision with simple conjunctival closure still lege artis?]

    Eisenmann K, Zeman F, Helbig H, et al.

    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2020; (117(4)):359-365 doi:10.1007/s00347-019-00968-8.

    PMID: 31520116
  14. 14

    Conjunctival Autograft Combined With Either Preoperative Mitomycin C Injection or Intraoperative Local Mitomycin C Over the Medial Rectus Muscle Tendon in Primary Pterygium Surgery.

    Lotfy A, Gad AAM, Abdelrahman A, et al.

    Eye & contact lens 2018; (44 Suppl 2()):S192-S195 doi:10.1097/ICL.0000000000000475.

    PMID: 29420324
  15. 15

    Limbal conjunctival versus amniotic membrane in the intraoperative application of mitomycin C for recurrent pterygium: a randomized controlled trial.

    Chen R, Huang G, Liu S, et al.

    Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 2017; (255(2)):375-385 doi:10.1007/s00417-016-3509-5.

    PMID: 27761704
  16. 16

    Mitomycin C in pterygium treatment.

    Martins TG, Costa AL, Alves MR, et al.

    International journal of ophthalmology 2016; (9(3)):465-8 doi:10.18240/ijo.2016.03.25.

    PMID: 27158622
  17. 17

    Applications of Mitomycin C in Cornea and External Disease.

    Crespo MA, Rapuano CJ, Syed ZA

    Turkish journal of ophthalmology 2023; (53(3)):175-182 doi:10.4274/tjo.galenos.2023.97932.

    PMID: 37345314
  18. 18

    Fibrin glue versus sutures for conjunctival autografting in primary pterygium surgery.

    Romano V, Cruciani M, Conti L, Fontana L

    The Cochrane database of systematic reviews 2016; (12()):CD011308 doi:10.1002/14651858.CD011308.pub2.

    PMID: 27911983
  19. 19

    Fibrin Glue Versus Sutures for Securing Conjunctival Autograft in Primary Pterygium Surgery: A Systematic Review and Meta-Analysis.

    Tsai JHJ, Tan EJ, Au Eong JTW, et al.

    American journal of ophthalmology 2026; (283()):313-323 doi:10.1016/j.ajo.2025.12.004.

    PMID: 41419075
  20. 20

    Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Network Meta-Analysis of Randomized Trials.

    Terres MT, Hira S, de Avila MF, et al.

    American journal of ophthalmology 2026; (285()):240-253 doi:10.1016/j.ajo.2026.02.005.

    PMID: 41679367
  21. 21

    Comparison of free conjunctival autograft versus amniotic membrane transplantation for pterygium surgery.

    Akbari M, Soltani-Moghadam R, Elmi R, Kazemnejad E

    Journal of current ophthalmology 2017; (29(4)):282-286 doi:10.1016/j.joco.2017.08.003.

    PMID: 29270475
  22. 22

    [Pterygium: pathogenesis, diagnosis and treatment].

    Rokohl AC, Heindl LM, Cursiefen C

    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2021; (118(7)):749-763 doi:10.1007/s00347-021-01366-9.

    PMID: 33782734

This page explains pterygium surgery options and risks for informational purposes only and does not constitute medical advice. Your ophthalmologist should recommend the technique, graft, medicines, and follow-up plan for your individual eye.