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

Ophthalmic Surg Lasers. Jul-Aug 2000;31(4):301-7.

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • 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
  • Pterygium / pathology
  • Pterygium / surgery*
  • Safety
  • Secondary Prevention
  • Transplantation, Autologous
  • Wound Healing / drug effects

Substances

  • Alkylating Agents
  • Ophthalmic Solutions
  • Mitomycin