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The following is a summary of “Safety of Office-Based Pterygium Surgery,” published in the February 2025 issue of American Journal of Ophthalmology by Cremers et al. 

Pterygium surgery is the most frequently performed ocular surface procedure globally, with a growing shift towards office-based hospital and ambulatory eye surgeries. 

Researchers conducted a retrospective study to evaluate the safety, complication rate, cost-savings, and cosmetic satisfaction of office-based pterygiectomy. 

They performed 1,071 office-based pterygiectomies between 2013 and 2016, led by 2 board-certified ophthalmologists using a Zeiss surgical microscope under topical anesthesia and oral sedation. The procedures took place in an office suite, with follow-up visits scheduled at 1 day, 2 weeks, 1 month, 2 months, 3 months, 6 months, and 1 year. Data collected were pterygium location (nasal, temporal, or both), type (primary or recurrent), and treatments (mitomycin C, fibrin glue, amniotic membrane). Measures included preoperative and postoperative refraction, intraocular pressure (IOP), endothelial cell density (ECD), patient-reported pain (11-point visual analog scale), cosmetic satisfaction, surgical time, speculum width, ptosis incidence (2 mm decrease in MRD1), and complications. The average operational and procedural costs were compared with those from local surgical centers and academic hospitals. 

The results showed that 1,015 pterygia from 992 eyes were examined postoperatively. A case of central retinal artery occlusion occurred at week 2 due to peribulbar anesthetic with epinephrine, leading to the removal of epinephrine from the regimen. At the 1-year follow-up, 393 pterygium cases in 343 eyes were examined and 1 -year complication rates included recurrence (2.04%, N=8/393), dellen (3.05%, N=12/393), granuloma (3.82%, N=15/393), and ptosis (2.6%, N=9/343) with no infections. Patient-reported pain remained below 1.0, and cosmetic satisfaction was above 88%. The average cost for office-based surgery was $1795 ($1700-$1890), compared to $3812.50 ($2625-$5000) at local surgical centers and $5562 ($5095-$6029) at hospitals. 

Investigators concluded that office-based pterygiectomy was a safe, cost-effective procedure associated with low recurrence rates and high patient satisfaction. 

Source: ajo.com/article/S0002-9394(25)00053-4/abstract