Low-dose intraoperative mitomycin-C versus conjunctival autograft in primary pterygium surgery: long term follow-up.

Abstract

PURPOSE:

To evaluate and compare the long term safety and efficacy of low-dose intraoperative application of mitomycin-C (0.02%) with conjunctival autograft in primary pterygium surgery.

PATIENTS AND METHODS:

Of 37 consecutive patients 41 eyes with primary pterygium underwent pterygium excision with either intraoperative mitomycin-C (0.02%) (Group I) or conjunctival autografts (Group II) at random. Mitomycin-C (0.2 mg/mL) was applied for 2.5 minutes on the scleral bed under the conjunctiva. Conjunctival autograft was obtained from upper temporal limbus and secured with 10-0 monofilament nylon. The follow-up period ranged from 14 to 54 months (mean 36 months) for mitomycin-C group and 13 to 58 months (mean 38 months) for conjunctival autograft group.

RESULTS:

Twenty-one eyes underwent pterygium excision with intraoperative mitomycin-C (0.02%) application (Group I) and 20 eyes were treated using conjunctival autograft (Group II). The mean size of the pterygium was 3.80 mm (range 2.6 to 4.8 mm) in the mitomycin-C group and 3.60 mm (range 2.5 to 4.5 mm) in the conjunctival autograft group. Two (9.52%) eyes treated with intraoperative mitomycin-C had delayed epithelial healing of corneoscleral wound and one (4.76%) eye developed pyogenic granuloma. Three (14.3%) of the 21 eyes in Group I and one (5%) of 20 eyes in Group II had recurrence of pterygium (P = 0.3174). All recurrences occurred in patients below 40 years of age (P = 0.0384).

CONCLUSION:

We conclude that conjunctival autograft and intraoperative mitomycin-C are both equally effective adjuncts to primary pterygium surgery on long term follow-up. However, future prospective studies with larger numbers of subjects may be carried out to find out the optimum concentration and duration of intraoperative mitomycin-C application.

• Authors: A Sharma, A Gupta, J Ram, A Gupta
• Journal: Ophthalmic surgery and lasers (Ophthalmic Surg Lasers) 2000 Jul-Aug Vol. 31 Issue 4 Pg. 301-7 ISSN: 1082-3069 [Print] United States
• PMID: 10928667 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Alkylating Agents
• Ophthalmic Solutions
• Mitomycin

Topics

• Adult
• Alkylating Agents (administration & dosage)
• Conjunctiva (transplantation)
• Female
• Follow-Up Studies
• Humans
• Intraoperative Period
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Ophthalmic Solutions
• Prospective Studies
• Pterygium (drug therapy, pathology, surgery)
• Safety
• Secondary Prevention
• Transplantation, Autologous
• Wound Healing (drug effects)