Femtosecond Laser-Assisted Surgery For Advanced Pterygium: A Novel Approach For Precise Excision And Autograft Implantation

To evaluate the feasibility and clinical outcomes of femtosecond laser-assisted excision and autograft implantation in patients with Grade III pterygium, where corneal involvement and refractive changes necessitate high surgical precision.

This study was conducted in a specialized ophthalmic surgical center. All procedures were performed using the Victus femtosecond laser, applying a modified ICRS tunnel pattern for sublesional cleavage plane creation. A contact lens interface was utilized to enable superficial laser application. Patients underwent standardized preoperative and postoperative evaluations at 1 and 3 months, including visual acuity, refraction, and corneal topography

A retrospective study was conducted on 5 patients with Grade III pterygium. Preoperative and postoperative evaluations at 1 and 3 months included visual acuity, refraction, and corneal topography. Surgery involved pterygium excision with fibrin glue-assisted autograft fixation (Tisseel). A Victus femtosecond laser was used to create a sublesional cleavage plane, modifying the ICRS tunnel creation pattern. A contact lens interface allowed for more superficial dissection, overcoming the platform’s 150 µm depth limitation.

Surgery was successful in all cases, achieving complete pterygium removal with smooth autograft integration. Uncorrected visual acuity improved from 0.35±0.2 to 0.67±0.21, while astigmatism decreased from 3.68±1.74D to 1.85±0.9D. No intraoperative or postoperative complications were observed. The femtosecond laser allowed for precise sublesional cleavage, minimizing scleral trauma and ensuring a uniform excision plane. OCT imaging confirmed accurate dissection depth, and postoperative healing was uneventful, with no signs of recurrence at 3 months. Patients reported reduced ocular discomfort and improved visual function postoperativel

Femtosecond laser-assisted pterygium surgery offers a precise, reproducible, and minimally traumatic approach for Grade III cases with central corneal involvement. The high-resolution OCT guidance and refined dissection technique improve surgical accuracy, particularly in patients with significant refractive and topographic alterations. This method may enhance outcomes in complex pterygium cases requiring high-precision excision and topographic regularization.