Intraoperative 96% ethanol as an adjuvant in Pterygium (Pt) surgery

• Published in: Acta ophthalmologica (Oxford, England) Vol. 100; no. S267
• Main Authors: Gancedo, Maria Luisa Perez, Reina, Alfonso Rubio, Martin, Laura Alonso, De Los Angeles Leal González, Maria, Leon, Maria Mercedes Cabezas, Vazquez, Maria Platero, Diaz, Oier Perez, Cardeñosa, Nuria Cuenca, De Paz, Sergio Pérez, Quiroz, Nolvis Marina Alvarez, Lozano, María Belén Morcillo, Rodríguez, Beatriz González, Serrano, Famara Doblado, Lopez, Fernando Sellers, Silva, Bruno Casco, García, Maria Josefa Fernández, Carranza, Maria Zulema Hernandez
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01-01-2022
• Subjects: Adjuvants; Cellulose; Cornea; Epithelium; Ethanol; Fibrin; Head; Iodine; Ophthalmology; Povidone; Surgery; Surgical outcomes; Tetracaine
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2022.033

Purpose
The aim of the study is to present how we use ethanol on the cornea next to the pterygium head to remove the corneal epithelium and create a dissection plane to remove the fibrovascular tissue in a more controlled way leaving a more regular corneal surface.
Methods
Topical tetracaine + oxybuprocaine as topical anaesthetic, povidone iodine 5% is instilled and mepivacaine 2% is injected under the body of the pterygium. A cellulose sponge soaked in 96% ethanol is placed over the corneal surface 1‐2 mm around the head of the fibrovascular tissue for 10 seconds, then washed. Blunt lifting of the epithelium towards the head of the pterygium allows identification of the surgical plane for dissection of the underlying corneal adhesions. Excision of the corneal encroaching tissue, tennon's capsule over the bare sclera and under the conjunctival wound was followed by conjunctival autograft sealed with fibrin (tisseel).
Results
A retrospective review of all pterygium procedures performed at our institution from January 2017 to January 2020 was performed to find out if there were any intra‐ or post‐surgical complications related to the use of 96% ethanol. All patients had completed epithelialisation within 1 week and none had limbal deficiency. The recurrence rate was very low.
Conclusions
Intrasurgical application of 96% ethanol on the cornea next to the pterygium head for 10 seconds just before surgical removal of the pterygium is an inexpensive, safe and effective adjuvant to the procedure. It may even be of more interest in recurrent pterygium where firm adhesions need to be addressed and creating a new smooth surface may prevent recurrences.
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