Double Trouble Following Pterygium Excision: A Case Report

Abstract

Pterygium is a common disease and the gold standard surgical treatment is excision with conjunctival autograft. Pterygium excision has various complications, including recurrence and rarely, conjunctival granuloma. Inflammation is a risk factor for postoperative pterygium recurrence and granuloma formation. Aside from steroids, adjuvants may be used to curb postoperative inflammation but has limited use due to its various side effects. Psoriasis, a systemic inflammatory disease, also affects the eyes. We report a case of a patient with psoriasis who underwent pterygium excision with conjunctival graft which was complicated with both granuloma and recurrence. The granuloma resolved with medical management and the recurrent pterygium was stable at one year after the initial surgery. Patients with inflammatory disorders require careful perioperative planning aimed to reduce postoperative inflammation and subsequent complications, and avoiding the need for a second surgery.