A clinical study of comparison of pterygium surgery with and without Mitomycin-C on bare sclera technique

Mohan Lal Gupta, Ravindra Kumar Meena, Veena Bhardwaj

Abstract


Introduction: A pterygium is a triangular wedge of fibro-vascular conjunctival tissue that appears on the epibulbar conjunctiva, which can be removed by various methods. Recurrence of Pterygium after exicision is a very common problem encountered by ophthalmologist. Several methods have been suggested to avoid these recurrences. We studied the recurrence rate of pterygium after application of intraoperative mitomycin C (0.04%). Method: This is a prospective study of fifty eyes in fifty patients who underwent pterygium excision by the same surgeon using intraoperative topical mitomycin C(25 patients) and without using mitomycin c(25 patients) during September 20014—September 2015 in the ophthalmology department at Jhalawar medical college, Jhalawar( raj.). 0.04% Mitomycin applied to bare sclera after excision for two minutes by swab sticks. Postoperative follow up period was 6 months. Outcomes measured in the form of recurrence and complications were analyzed. Results: In Group A with use of mitomycin C there was no recurrence after 6 months follow-up while in Group B recurrence was seen in 5 patients within 3-6 months, however in group A, 1 patient had scleral thinning. Conclusion: Intraoperative administration of mitomycin C 0.04% is safe and effective to prevent pterygium recurrences.

Full Text:

PDF HTML

References


Shinyoung Hwang, Sangkyung Choi A Comparative Study of Topical Mitomycin C, Cyclosporine, and Bevacizumab after Primary Pterygium Surgery Korean J Ophthalmol 2015;29(6):375-381 http://dx.doi.org/10.3341/kjo.2015.29.6.375

Mustafa Ozsutcu, Emre Ayintap, Julide C U Akkan, Arif Koytak, and Cengiz Aras Repeated bevacizumab injections versus mitomycin C in rotational conjunctival flap for prevention of pterygium recurrence Indian J Ophthalmol. 2014 Apr; 62(4): 407–411. doi: 10.4103/0301-4738.120220.

Kria L, Ohira A, Amemiya T. Immunohistochemical localization of basic fibroblast growth factor, platelet derived growth factor, transforming growth factor-beta and tumor necrosis factor-alpha in pterygium. Acta Histochem. 1996;98:195–201.

Aspiotis M, Tsanou E, Gorezis S, Ioachim E, Skyrlas A, Stefaniotou M, et al. Angiogenesis in pterygium: Study of microvessel density, vascular endothelial growth factor, and thrombospondin-1. Eye (Lond) 2007;21:1095–101. [PubMed]

A L Young, G Y S Leung, A K K Wong, L L Cheng, D S C LamA randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygiumBr J Ophthalmol 2004;88:995–997. doi: 10.1136/bjo.2003.036830

David Hui-Kang Ma, Lai-Chu See, Su-Bin Liau, Ray Jui-Fang Tsai .Amniotic membrane graft for primary pterygium: comparison with conjunctival autograft and topical mitomycin C treatment Br J Ophthalmol 2000;84:973–978

Halit Oguz1, Emel Basar2 and Bulent Gurler1 Intraoperative application versus postoperative mitomycin C eye drops in pterygium surger Acta Ophthalmol. Scand. 1999: 77: 147–150

Gabor Koranyi,1 Ditte Artze´ n,2 Stefan Seregard2 and Eva Dafgard Kopp2 Intraoperative mitomycin C versus autologous conjunctival autograft in surgery of primary pterygium with four-year follow-up. Acta Ophthalmol. 2012: 90: 266–270 ª 2010 The Authors Journal compilation ª 2010 Acta Ophthalmol

doi: 10.1111/j.1755-3768.2010.01936.x.

Mutlu FM, Sobaci G, Tatar T, Yildirim E. A comparative study of recurrent pterygium surgery: Limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology. 1999;106:817–21. [PubMed]

Chen PP, Ariyasu RG, Kaza V, LaBree LD, McDonnell PJ. A randomized trial comparing mitomycin C and conjunctival autograft after excision of primary pterygium. Am J Ophthalmol. 1995;120:151–60. [PubMed]

Manning CA, Kloess PM, Diaz MD, Yee RW. Intraoperative mitomycin in primary pterygium excision. A prospective, randomized trial. Ophthalmology. 1997;104:844–8. [PubMed]

Alpay A, Ugurbas SH, Erdogan B. Comparing techniques for pterygium surgery. Clin Ophthalmol.2009;3:69–74. [PMC free article] [PubMed]

Lam DS, Wong AK, Fan DS, Chew S, Kwok PS, Tso MO. Intraoperative mitomycin C to prevent recurrence of pterygium after excision: A 30-month follow-up study. Ophthalmology. 1998;105:901–4. [PubMed]

Allan BDS, Short P, Crawford GJ, et al. Pterygium excision with conjunctival autografting: an eVective and safe technique. Br J Ophthalmol 1993;77:698–701

Rubinfeld RS, Pfister RR, Stein RM, Foster CS, Martin NF, Stoleru S, et al. Serious complications of topical mitomycin-c after pterygium surgery.Ophthalmology.1992;99:1647-54.[PubMed]

Safianik B, Ben-Zion I & Garzozi HJ (2002): Serious corneoscleral complications after pterygium excision with mitomycin C. Br J Ophthalmol 3: 357–358.

Zhivov A, Beck R & Guthoff RF (2009): Corneal and conjunctival findings after mitomycin C application in pterygium sur- gery: an in-vivo confocal microscopy study. Acta Ophthalmol 2: 166–172.

Peponis V, Rosenberg P, Chalkiadakis SE, Insler M & Amariotakis A (2009): Fungal scleral keratitis and endophthalmitis fol- lowing pterygium excision. Eur J Ophthal- mol 3: 478–480.

Rodriguez JA1, Ferrari C, Hernández GA. Intraoperative application of topical mitomycin C 0.05% for pterygium surgery. Bol Asoc Med P R. 2004 Mar-Apr;96(2):100-2.


Refbacks

  • There are currently no refbacks.