Does Pterygium Surgery Hurt?

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Video Transcript

Does pterygium surgery hurt?
Hi, I’m Dr. Rylan Hayes – ophthalmologist and specialist pterygium surgeon here on the Sunshine Coast. This is one of the most common questions I hear, and I understand why. The eye is sensitive. The idea of eye surgery can feel daunting. During the procedure itself, no. You are sedated with a twilight anesthetic, and the eye is completely numbed with a local anesthetic before we begin. And I won’t proceed until I’m confident you’re comfortable. You may feel some light pressure or movement, but sharp pain is not to be expected. After surgery is where the traditional answer was very different. Traditional suture-based pterygium surgery was known for causing significant and prolonged discomfort, sometimes weeks. That experience is a major reason I tried to develop a much more patient-friendly no-stitch technique. With my signature no-stitch pterygium surgery, most patients experience only mild discomfort in the first day or two, and most find that paracetamol is all they need. While we do provide prescriptions for pain relief as well, the majority of patients don’t end up using it. If you’ve been putting off pterygium surgery because you’re worried about pain, I’d encourage you to come and have that conversation with me, and we can discuss what we can achieve for your pterygium.

Does Pterygium Surgery Hurt?

Pain is one of the most common concerns patients raise about pterygium surgery — and it’s an entirely reasonable one. The eye is one of the most sensitive structures in the body, and the reputation of traditional pterygium surgery for being painful has put many people off seeking treatment. Here’s an honest account of what to expect.

During the procedure

The Signature No-Stitch Pterygium Surgery is performed under twilight anaesthetic sedation with local anaesthetic injection , which numb the ocular surface thoroughly before the procedure begins. Dr Hayes will not start until he is satisfied that the eye is adequately anaesthetised.

During surgery:

• Sharp pain is not expected
• Sensations of light pressure, cold liquid, movement, or touch may be perceived — this is the normal sensory experience
• If you are becoming more conscious and significant discomfort is experienced at any point, additional anaesthetic is applied immediately

Immediately after surgery

As the local anaesthetic wears off in the evening after surgery, some discomfort is expected. This is typically described as:

• Grittiness or a foreign body sensation
• Mild burning or stinging
• Light sensitivity
• Watery eyes

This is the normal post-operative experience and is managed with prescribed analgesic and anti-inflammatory eye drops.

The no-stitch difference

This is where the Signature No-Stitch Pterygium Surgery differs significantly from traditional stitched techniques.

Traditional suture-based pterygium surgery involves placing stitches on the surface of the eye. These sutures sit directly on the conjunctiva — a surface extraordinarily rich in sensory nerve endings. The resulting discomfort has historically been significant, with many patients describing persistent, considerable pain for weeks after surgery.

By using Tisseel fibrin adhesive instead of sutures, this source of prolonged discomfort is eliminated. The result: the vast majority of Dr Hayes’s patients report only mild discomfort for one to two days — with most finding paracetamol sufficient.

Prescription analgesics are provided for all patients as a safety net, but the majority do not require them.

Key Takeaways

• During surgery, the eye is fully numbed with local anaesthetic — sharp pain during the procedure is not expected
• Traditional suture-based pterygium surgery is known for significant and prolonged post-operative pain
• The Signature No-Stitch Pterygium Surgery eliminates suture￾related discomfort — most patients need only paracetamol for one to two days
• Prescription analgesia is provided but rarely needed

Worried about pain from pterygium surgery?

Book a consultation with Dr Rylan Hayes at The Vision Surgeon, Maroochydore — and let’s talk about it.

References

• Kaufman SC, et al. Fibrin glue vs sutures for pterygium surgery — patient comfort outcomes. J Cataract Refract Surg. 2003.
• Ang M, et al. Fibrin glue versus sutures for conjunctival autografting in pterygium surgery. Cochrane Database Syst Rev. 2021.
• American Academy of Ophthalmology. Pterygium — Preferred Practice Pattern. aao.org