Late complications of pterygium treatment

Long-term complications of pterygium excision and beta irradiation in 63 eyes of 57 patients are described. The age of the patients at treatment ranged from 27 to 69 years (mean 48 +/- 11), and complications were assessed 3 to 20 years later (mean 12 +/- 3). The pterygia were excised, leaving bare sclera, and beta irradiation of total dose 750 to 5200 rads (mean 3475 +/- 916) was given, except in 7 patients who had repeated courses or overlapping fields of beta irradiation. Scleral ulceration was present in 51 eyes and sectorial lens opacities with normal visual acuity (VA) in 19 eyes. Radiation induced cataract occurred in 3 eyes, with reduced vision. Ptosis, symblepharon, and iris atrophy were also seen. Pseudomonas endophthalmitis occurred in 4 patients with scleral ulceration. Beta irradiation to prevent recurrence of pterygia is a significant cause of iatrogenic ocular disease. There is a need to modify the beta irradiation dosimetry at present in use.