Abstract | PURPOSE: To determine if a pterygium surgical procedure consisting of minimal conjunctival removal, excision of the hypertrophic subconjunctival fibrovascular tissue, application of mitomycin 0.25 mg/mL for 1 minute combined with temporary nasal tarsorrhaphy, and use of postoperative dexamethasone/ antibiotic drops achieves the following: safely simplifies pterygium removal, controls the early side effects of mitomycin, reduces the rate of recurrence, and lessens the need for conjunctival transplantation. METHODS: Twenty eyes in 19 patients underwent the procedure with use of mitomycin; 15 eyes had primary and 5 had recurrent pterygia. These were compared with a previous group of 28 eyes in 26 patients that underwent pterygium/tarsorrhaphy surgery without use of mitomycin; 20 eyes had primary and 8 had recurrent pterygia. Postoperatively, all eyes in both groups were treated with dexamethasone/ antibiotic drops. RESULTS: In the mitomycin group, with an average follow-up of 12.1 months, 19 eyes healed uneventfully; there have been no recurrences. The nonmitomycin group, with an average follow-up of 42.6 months, has had nine recurrences (32%); four required a second procedure. Recurrence was significantly lower in the mitomycin group (P = .006). Conjunctival healing, as reflected in the time from surgery until tarsorrhaphy opening, was significantly delayed in the mitomycin group, 36.7 versus 17 days (P = .001). The delay in conjunctival healing may explain the complications associated with the use of mitomycin in pterygium surgery. CONCLUSION: Minimal conjunctival removal, extensive fibrovascular tissue excision, 1-minute application of mitomycin 0.25 mg/mL, temporary nasal tarsorrhaphy, and frequent application of dexamethasone/ antibiotic drops postoperatively provided a safe and successful approach to pterygium management in this series.
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Authors | Thomas O Wood, Ellen E Williams, Danielle L Hamilton, Bryan L Williams |
Journal | Transactions of the American Ophthalmological Society
(Trans Am Ophthalmol Soc)
Vol. 103
Pg. 108-14; discussion 114-5
( 2005)
ISSN: 1545-6110 [Electronic] United States |
PMID | 17057794
(Publication Type: Controlled Clinical Trial, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Glucocorticoids
- Nucleic Acid Synthesis Inhibitors
- Mitomycin
- Dexamethasone
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Topics |
- Adult
- Aged
- Anti-Bacterial Agents
(therapeutic use)
- Dexamethasone
(therapeutic use)
- Drug Therapy, Combination
- Eyelids
(surgery)
- Female
- Glucocorticoids
(therapeutic use)
- Humans
- Male
- Middle Aged
- Mitomycin
(adverse effects, therapeutic use)
- Nucleic Acid Synthesis Inhibitors
(adverse effects, therapeutic use)
- Ophthalmologic Surgical Procedures
(adverse effects)
- Postoperative Care
- Postoperative Complications
(pathology, prevention & control)
- Pterygium
(drug therapy, pathology, surgery)
- Secondary Prevention
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