New technique uses alcohol to 'scrape away' pterygium

STOCKHOLM, Sweden — A simple procedure that uses alcohol 20% solution is proving effective in the treatment of pterygium, according to a surgeon at Soroka University, Beer-Sheva, Israel.

In Israel, due to the dry, hot climate, the incidence of pterygium is high, and the difficulties in treating this condition are well known.

"Alcohol allows us to scrape the pterygium completely from the cornea, and we have had so far a very low recurrence rate," said Erez Tsumi, MD, at the European Society of Cataract and Refractive Surgeons meeting.

The procedure, which Dr. Tsumi said was inspired by LASEK, is simple and straightforward.

After subconjunctival lidocaine injection, a metal ring is placed above the head of the pterygium to isolate the treatment area. A few drops of ethanol 20% are applied inside the ring and left in place for 40 seconds. The alcohol is then washed out with balanced salt solution.

"After having been soaked in alcohol, the pterygium is easily separated from the underlying cornea with a blunt spatula by scraping it away at the periphery and then at the center. At the end, mitomycin-C 0.02% is applied for 2.5 minutes. The ocular surgery is then profusely washed," he explained.

In a retrospective study of 29 eyes with primary pterygium and two eyes with recurrent pterygium that underwent this procedure, results were encouraging. There were no intraoperative complications, and no severe side effects were reported during the follow-up, which ranged from 6 months to 12 months. No cases of recurrence were observed.

"This technique creates a very clear and smooth separation plane between the pterygium and the underlying cornea. The alcohol allows you an easy access to the dissection plane, which is so difficult to find with the more traditional blunt dissection technique," Dr. Tsumi said.

Safety and efficacy of the technique will be further investigated in a prospective study at the same hospital.