Histopathological Characteristics of Surgically Excised Pterygium

Background: Pterygium is a common degenerative ocular surface disorder with variable clinical behaviour and risk of recurrence. Histopathological evaluation helps in understanding disease activity, progression, and factors associated with recurrence. This study aimed to analyse histopathological changes in excised pterygium specimens and their association with clinical features. Methods: A prospective study was conducted on 85 patients who underwent pterygium excision with conjunctival autograft, including fixation using autologous serum. Excised tissues were processed for routine histopathology and stained with H&E, Masson’s trichrome, Gomori’s reticulin, and PAS. Inflammation, vascularisation, and fibrinoid degeneration were graded semi-quantitatively. Clinical and histopathological data were statistically analysed using SPSS software. Results: Mild to moderate inflammation was most common, with Grade 1 changes seen in 34.1% of cases. Moderate to marked vascularisation and fibrinoid degeneration (Grades 2 and 3) were observed in over 60% of specimens, indicating active fibrovascular pathology. Higher grades of inflammation, vascularisation, and fibrinoid change were significantly more frequent in patients with Fuchs’ spots. Recurrent pterygia also demonstrated a greater proportion of moderate to severe histopathological changes. Conclusion: Histopathological severity correlates with clinical progression and recurrence of pterygium, emphasizing the importance of thorough excision and careful postoperative follow-up