Rapid growth of pterygium after photorefractive keratectomy

A pterygium is a fibrovascular overgrowth of degenerative conjunctiva over the limbus onto the cornea. The risk factors for pterygium development include exposure to ultraviolet (UV) light, dust, wind, heat, dryness, and smoke. As far as we are aware, rapid growth of pterygium secondary to photorefractive keratectomy (PRK) has not been reported previously.

A 49-year-old man presented with blurring vision in the left eye. The patient had undergone PRK in both eyes at another surgical center 11 months prior. Examination found a pterygium extending 3 mm over the corneal midline and covering 60% to 70% of the cornea. Information regarding the extent of the pterygium in the left eye was limited; however, preoperative drawings showed a moderate extension of about a 3-mm encroachment into the nasal cornea. However, the patient stated that the 2 sides "looked similar" before PRK and that the right side remained "pretty small" after surgery.

Several growth factors have been detected in the cornea during the recovery from PRK surgery. Those growth factors might have the potential to exacerbate the growth of a pterygium. Further studies are needed to draw any conclusion regarding the consequence of PRK surgery on the growth of a pterygium so patients can be better informed and managed. As eye care providers, we should be aware of the potential that rapid growth of a pterygium may occur after PRK.