In Chinese medicine, pterygium is called “pterygium climbing eye”, commonly known as “fish meat”. It is a very common conjunctival degenerative disease. It is a kind of superfluous tissue on the bulbar conjunctiva and cornea of the blepharosphene, which invades the cornea and increases in size day by day, and even covers the pupil area and seriously affects the vision. It is a degeneration, hypertrophy and hyperplasia of the conjunctiva and subconjunctival tissues in the blepharosphenoid region, which develops towards the cornea and is triangular, like a wing, hence the name. It is mostly seen in outdoor workers, with fishermen and farmers having the most incidence, and may be related to long-term chronic irritation from wind, dust, sunlight and smoke. Pterygium is generally used as an introductory ophthalmic microsurgery, but doing a good pterygium is actually not easy. A good pterygium surgery cannot be seen in the short term, but many problems are often slowly revealed after 1 month postoperatively, and some of the complications are alarming. But what makes a good pterygium surgery? What makes a successful pterygium surgery? I do about 300 cases of pterygium excision and corneal limbal stem cell transplantation (including my original stem cell glide transplantation) in more than 400 eyes and more than 100 cases of pterygium excision alone every year. According to my experience, the following principles need to be grasped for good pterygium surgery: 1. Minimally invasive: reduce unnecessary trauma. We know that, in a sense, pterygium is actually a proliferative disease due to UV damage, somewhat similar to scarring. Therefore, any unnecessary trauma such as cauterization, excessive scratching, shearing, etc. will result in scarring, which may lead to severe lid adhesions (as will be shown in the pictures later) and accelerate the recurrence of the pterygium. The traditional surgical approach of cutting the pterygium at the root after dissecting along the tip of the pterygium with a razor blade is highly undesirable because it is too traumatic and can easily damage the anterior elastic lamina and the superficial stroma, resulting in the formation of a white scar in the pterygium growth area of the cornea. The retrograde tearing procedure for pterygium removal is not only less traumatic, but also clean and smooth, leaving no traces on the surface of the cornea after the operation. 2, clean: the removal of pterygium cells and fibroblasts should be clean. As we know, in the process of pterygium, ultraviolet light reflection focuses on the nasal corneal limbus -> damages the corneal limbal stem cells here -> inflammation further destroys the stem cell barrier -> Stem cells proliferate and transform -> pterygium cells (bosporin-positive stem cells) -> invade the cornea. Thus, a pterygium primarily presents as a proliferation of fibrocollagenous tissue in the subconjunctiva. If the excision process is not clean and thorough enough, the remaining pterygium cells will repopulate and invade the cornea. Neatness: The more neatly the conjunctival wounds are aligned, the less inflammatory reaction there will be, the less foreign body sensation there will be, the smaller the scars will be, and the more natural the appearance will be.