Pterygium after hyperopic laser‐assisted sub‐epithelial keratomileusis (LASEK)

A 61‐year‐old Caucasian woman with hyperopia presented for laser refractive surgery. She had healthy eyes with the exception of a less than 0.5 mm Salzmann's nodule at 5 o'clock near the limbus of the right eye. She underwent bilateral hyperopic laser‐assisted sub‐epithelial keratomileusis (LASEK) combined with removal of the Salzmann's nodule. At six months, she was emmetropic with unaided vision of 6/6; however, at 10 months, she noticed a reduction of acuity in her right eye and was found to have a pterygium at 5 o'clock, encroaching 3.5 mm onto the corneal surface. She underwent excision biopsy, local application of mitomycin‐C (0.2 mg/ml for two minutes) and conjunctival auto‐grafting. Following surgery for the pterygium, vision returned to 6/6 unaided but six months later, there was limited recurrence (1.5 mm) of the pterygium reducing unaided vision to 6/9, due to the induction of astigmatism of ‐1.25 dioptres. This has remained stable for 14 months. Pterygium growth may be associated with surface excimer laser surgery and the presence of peripheral Salzmann's nodules might be a risk factor.