Pterygium & Pinguecula Removal Risks
Pterygium and pinguecula removal are safe, well-established procedures with high success rates, but no surgery is completely risk-free. Blue Fin Vision® provides consultant-led care, using advanced microsurgical and laser techniques to minimise risk and manage any complications safely.
How Safe is Pterygium & Pinguecula Removal?
Pterygium and pinguecula removal are considered low-risk procedures with excellent outcomes when performed by experienced specialists. Modern techniques, including conjunctival autografting for pterygium and argon laser photocoagulation for pinguecula, deliver effective results for the vast majority of patients. Serious complications are rare, and most side effects are temporary and manageable.
At Blue Fin Vision®, all procedures are delivered within UK clinical governance, including CQC oversight and audited outcomes. Consultant-led assessment ensures the most appropriate technique is selected for your condition, maximising safety and minimising recurrence risk.
Normal Side Effects After Surgery
Some changes in the first few days after pterygium or pinguecula removal are expected and usually settle as the eye heals. These short-term effects are not usually classed as complications:
- Redness around the surgical site, which can appear dramatic at first and may spread beyond the operated area
- Mild discomfort, grittiness or a foreign body sensation in the eye
- Watering and light sensitivity, particularly in bright conditions
- Temporary blurred vision due to surface healing and eye drops
- Mild swelling of the conjunctiva (chemosis) that resolves spontaneously
Most patients notice that redness and discomfort improve significantly within the first one to two weeks, with the eye continuing to settle over the following weeks.
Short Term Risks and Treatable Complications
A minority of patients experience issues that require additional treatment or closer follow-up. Many of these complications are treatable, particularly when recognised early.
Subconjunctival Haemorrhage
Bleeding beneath the conjunctiva is the most common early complication, reported in up to 39% of pterygium surgeries. This appears as a red patch on the white of the eye and typically resolves without treatment over one to two weeks. It does not affect vision or long-term outcomes.
Graft Swelling and Oedema
When a conjunctival autograft is used, mild swelling of the graft tissue is common in the early healing period. This typically settles with anti-inflammatory drops and time. More significant oedema may require closer monitoring but rarely affects the final outcome.
Graft Displacement or Retraction
In a small percentage of cases (under 1%), the conjunctival graft may shift, slide or retract from its intended position. This can occur if fixation is inadequate or due to early postoperative rubbing. If significant, repositioning surgery may be required, though minor retraction often heals without intervention.
Corneal Epithelial Defect
A localised epithelial defect on the cornea is common immediately after pterygium removal and typically heals within 24 to 48 hours. Larger defects may take longer to heal and require additional lubricating drops or a bandage contact lens.
Infection
Infection is uncommon but possible with any procedure that involves the eye surface. Signs include increasing redness, pain, discharge or worsening vision. Prompt treatment with antibiotics usually resolves infection quickly. Following aftercare instructions carefully, including using prescribed antibiotic drops, significantly reduces this risk.
Persistent Inflammation
Some degree of inflammation is expected after surgery and is controlled with anti-inflammatory drops. In some cases, inflammation may persist longer than expected, requiring extended or stronger drop treatment. Patients with a history of dry eye or ocular surface disease may be more prone to prolonged inflammation.
Long Term Risks After Cataract Surgery
Recurrence
Recurrence is the most significant long-term concern after pterygium removal. Recurrence rates vary considerably depending on surgical technique.
Modern techniques using conjunctival autograft with fibrin glue achieve the lowest recurrence rates. At Blue Fin Vision®, advanced surgical methods are employed to minimise this risk. Recurrence, if it occurs, typically appears within the first 3 to 12 months after surgery, though late recurrence is possible.
Pinguecula recurrence is less common than pterygium recurrence, as pinguecula tends to be less aggressive. However, new pinguecula can develop with continued UV exposure.
Corneal Scarring
Some degree of corneal scarring may remain after pterygium removal, particularly if the pterygium had extended significantly onto the cornea before surgery. This can cause mild haziness or irregular astigmatism. Early intervention, before the pterygium advances far onto the cornea, typically results in better visual outcomes.
Induced Astigmatism
Pterygium can cause astigmatism by distorting the corneal surface. Removal usually improves or resolves this astigmatism, but in some cases, residual or new astigmatism may occur due to scarring or tissue changes. This can usually be corrected with glasses or contact lenses if needed.
Dry Eye
Some patients experience worsening dry eye symptoms after pterygium or pinguecula removal. This is usually temporary and improves with lubricating drops. In some cases, dry eye may persist and require ongoing management. Interestingly, many patients with pre-existing dry eye notice improvement after surgery, as the abnormal tissue contributing to tear film instability has been removed.
Rare But Serious Complications
A very small proportion of patients experience rare complications that require prompt attention. These risks are important to understand, even though they occur in only a tiny minority of cases.
Scleral Thinning
Excessive removal of tissue or overuse of cautery during surgery can lead to thinning of the underlying sclera (the white of the eye). This is rare with modern techniques and careful surgical planning. Severe thinning may require patch grafting.
Diplopia and Restricted Eye Movement
In rare cases, scarring near the eye muscles can restrict eye movement and cause double vision. This is more likely with extensive or recurrent pterygium surgery. Scar release surgery may be required if symptoms are significant.
Granuloma Formation
A granuloma is a small inflammatory nodule that can form at the surgical site, typically due to suture material or tissue reaction. Granulomas are usually treated with steroid drops or, occasionally, minor surgical removal.
Complications from Mitomycin C
When mitomycin C (an antimetabolite) is used as an adjunct to reduce recurrence, rare complications can include delayed wound healing, scleral thinning, or prolonged inflammation. These risks are minimised by careful dosing and technique.
Risks Specific to Pterygium Removal
Pterygium removal carries some specific considerations:
- Higher recurrence risk than pinguecula due to the more aggressive nature of the growth
- Corneal involvement means careful dissection is required to avoid deeper corneal damage
- Graft harvesting from the upper conjunctiva leaves a donor site that also needs to heal
- More extensive surgery for larger or recurrent pterygium increases complexity
Risks Specific to Pinguecula Removal
Pinguecula removal, whether surgical or laser, is generally lower risk than pterygium surgery:
- Lower recurrence rates as pinguecula is less aggressive
- Argon laser photocoagulation (available at Harley Street) is minimally invasive with rapid recovery
- No corneal involvement in most cases, reducing the risk of visual complications
- Smaller surgical field typically means faster healing
Who Has Higher Risk?
Some patients have a higher baseline risk of complications or recurrence. In these cases, treatment may still be appropriate, but the discussion is more individualised and expectations are tailored.
Higher-risk features can include:
- Younger age (under 40): Younger patients have more robust healing responses, which paradoxically increases recurrence risk
- Recurrent pterygium: Secondary surgery has higher recurrence rates and increased complexity
- Large or fleshy pterygium: More extensive growths require more extensive surgery
- Dry eye disease: Pre-existing ocular surface disease increases inflammation and recurrence risk
- History of keloid scarring: Patients prone to excessive scarring may have higher recurrence rates
- Continued UV exposure: Ongoing sun exposure without protection increases recurrence risk
- Darker skin types: Some studies suggest higher recurrence rates in certain ethnic groups
These factors do not automatically rule out treatment, but they may influence technique selection, use of adjunctive treatments like mitomycin C, and the intensity of follow-up after surgery.
Red Flag Symptoms to Act On
Understanding which symptoms are expected and which need urgent attention is a key part of safe recovery. Patients receive written instructions, but it can help to have a simple checklist in mind.
Seek urgent eye care if you notice:
- Sudden, severe eye pain or rapidly worsening vision
- Increasing redness with discharge, especially if yellow or green
- Significant swelling that worsens rather than improves
- Signs of graft displacement (if a graft was used)
- Sensitivity to light with reduced vision
- Any symptoms that worsen rather than improve after the first few days
Milder symptoms such as slight redness, mild discomfort or watering are often part of normal healing, but if there is any doubt, it is safer to contact the clinical team for advice. Early review allows most complications to be treated promptly, protecting your vision and supporting a smoother recovery.
Blue Fin Vision® Safety Standards
At Blue Fin Vision®, we follow rigorous protocols to minimise surgical risk:
- Detailed pre-operative assessment including evaluation of pterygium or pinguecula size, corneal involvement, and ocular surface health
- Consultant-led surgical technique using advanced microsurgical methods and conjunctival autografting with fibrin glue where appropriate
- Argon laser photocoagulation for suitable pinguecula cases at our Harley Street clinic, offering a minimally invasive alternative
- UK-regulated care within CQC oversight, audited outcomes and infection-control protocols
- Structured post-operative follow-up to monitor healing, detect recurrence early and address concerns
- Lifestyle guidance including UV protection advice to reduce recurrence risk
Your safety and visual outcome are our absolute priority. If you have concerns about your suitability for pterygium or pinguecula removal, our expert team is here to discuss your individual risk profile and help you make an informed decision.
Book your consultation today to discuss pterygium or pinguecula removal and understand how treatment can be tailored to your needs.
