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Gulani Academy: Pterygium Surgery

Created on: Sunday, February 23, 2020

It’s my pleasure to share with many eye surgeons who requested this video.
Joe was referred to me after Pterygium surgery complication With scleral melt and extensive scarring including a calcific plaque that restricted mobility and caused severe pain Along with decreased vision.
In this video besides being one of the first of using combination of no-stitch oligen and human placenta with the Tisseel glue, I am sharing my attitude of no matter how complex the situation is to never forget that I want full functional anatomy along with a cosmetic endpoint.
I approach this case as I’ve described in my textbook for pterygium surgery @thieme.ny step-by-step first defining the anatomy and not getting scared by the appearance or the complexity of what is in front of me.
As I define the anatomy I find that the previous surgeon’s pterygium is still present, then I start defining the conjunctival anatomy and finally reach the medial rectus muscle to free that up from this tangled mass of scars.
Always keeping in mind that I still want a cosmetic appearance despite this extensive and laborious surgery, I Lift the calcium plaque and study the scleral melt below and after good clearance, now place the Ologen graft On this area and squeegeed along the globe to be followed by receiving the placenta Which I lay over this graft and tuck into the surrounding conjunctival pockets and then use glue for the “No Sitch” placement.
Father, I proceed to suture the medial conjunctival area to re-create the angle and anatomy.
Finally, I determine a good anatomical recovery with best cosmetic outcome I could arrange along with good extraocular movements and clear cornea To completion.
The hug from this patient next day on complete resolution of symptoms that he was bearing for years, improved vision and appearance of the eye Reminded me why I keep fighting for every patient’s eye with the privilege we all have been given.

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