Laser Pterygium Surgery: 100% recurrence rate reported thus far

 2000 Jan-Feb;31(1):8-12.

Clinical application of Er:YAG laser for the treatment of pterygium.



To evaluate the clinical application of Er:YAG laser for the treatment of pterygium.


Five patients (5 eyes) with pterygium, 2 primary cases and 3 retreatment cases, whose ages ranged from 44 to 68 years (mean 54.4 years), were treated with the Er:YAG laser. The optical system consisted of a fluorozirco-aluminate glass fiber and a handpiece tip made of quartz glass. The tip of the guiding probe was applied to the surface of the pterygium, where the laser beam was emitted. The radiant energy was set at 10 mJ with water spray.


The removal of pterygium was accomplished under topical anesthesia with a laser output approximate range from 50 to 100 shots. Complications such as corneal erosion or thinning of the sclera were not observed. However, recurrence was seen in the 3 retreatment cases.


The Er:YAG laser system may be a clinically useful tool as a laser surgical knife for ocular tissue.
Old article: using laser after Pterygium excision with standard surgery:
 1997 May;235(5):296-305.

Therapeutic use of the 193-nm excimer laser in corneal pathologies.



To analyze the results of phototherapeutic keratectomy.


We performed 193-nm excimer laser phototherapeutic keratectomy (PTK) in 252 eyes of 216 patients suffering from pain and/or decrease in visual acuity. One hundred and three eyes had recurrent erosions of the cornea, 86 eyes underwent excimer laser smoothing of the cornea after pterygium surgery, 29 eyes had a bandlike keratopathy (25 rough, 4 smooth) and 34 eyes had other pathologic conditions such as amyloidosis of the cornea, anterior corneal dystrophies, scars after injuries, alkali burns, superficial stromal dystrophies and infections. Recurrent erosions and epithelial dystrophies were treated with 15-20 pulses (160-200 mJ/cm2, 8 mm ablation zone) after mechanical abrasion of the epithelium. Removal of corneal opacities and scars required the use of a masking fluid (methyl-cellulose) in different concentrations and slit-lamp control (integrated in the delivery system of the excimer laser).


Some 91% of the eyes with recurrent erosions were recurrence-free. Fifty-two per cent of the eyes with pterygium had recurrences if the baresclera technique was used and 33% of the eyes if a free conjunctival graft was used. The difference was not significant. All of the patients with bandlike keratopathy were pain-free. In 88% of the eyes with special indications the treatment goal was achieved. No positive effect was seen after alkali burn, in a patient with anterior membrane dystrophy (Grayson-Wilbrandt corneal dystrophy) or in a patient with a corneal protuberance. In one patient with scleroperikeratitis a late recurrence of the opacity was observed 3 years after surgery. A loss of best corrected visual acuity was found only in one patient with bullous keratopathy in whom the treatment goal was the reduction of pain. All patients with smooth bandlike keratopathy had an improvement in best corrected visual acuity of at least one line. About 70% of patients with special indications improved by at least one line, up to nine lines. A possible hyperopic shift in all groups could be minimized using a large ablation zone.


PTK with the 193-nm excimer laser is a safe and effective treatment for many superficial diseases of the cornea.
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