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Comparison of single-drop mitomycin C regime with other mitomycin C regimes in pterygium surgery
1Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Purpose:
To evaluate the safety and efficacy of single-drop instillation of mitomycin C (MMC) in pterygium surgery and to compare the results with both postoperative and intraoperative application of MMC.
Methods:
Eighty eyes of 72 patients with pterygium were randomised into 4 equal groups: group 1--control--bare scleral excision (BSE); group 2--BSE with single-drop instillation of mitomycin C (MMC) 0.02% at the end of the surgery; group 3--BSE with postoperative MMC 0.02% drops twice a day for 5 days; and group 4--BSE with intraoperative MMC 0.02%.
Results:
The recurrence of pterygium was observed in 14 (70%), 4 (20%), 4 (20%) and 3 (15%) eyes of group 1, 2, 3, and 4 respectively. The recurrence rate after BSE with single drop MMC regime (group 2) was significantly lower than group 1 recurrence (P=0.001) and was statistically comparable to that of group 3 and 4. Scleral defects in the bare area occurred in 4 (20%), 16 (80%) and 16 (80%) eyes of group 2, 3, and 4 respectively. The incidence of scleral defects was significantly lower in group 2 compared to group 3 (P=0.0001) and group 4 (P=0.0001). Compared to group 1 and 2, a significant delay in wound epithelialisation occurred in group 3 (P=0.003) and 4 (P=0.004). An ischaemic area in the bare sclera developed in 8 (40%) and 6 (30%) eyes of group 3 and 4 respectively, while ischaemic area did not develop in group 1 and 2.
Conclusion:
Single-drop instillation of 0.02% mitomycin C following pterygium excision appears both safe and efficacious.
Insights
Single-drop mitomycin C (MMC) after pterygium surgery is safe and effective. This method significantly reduces recurrence and complications compared to other MMC applications, offering a promising approach for pterygium treatment.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Pharmacological Interventions
Background:
- Pterygium is a common ocular condition requiring surgical intervention.
- Recurrence and complications are significant challenges in pterygium surgery.
- Mitomycin C (MMC) is used to reduce pterygium recurrence, but optimal application methods are debated.
Purpose of the Study:
- To assess the safety and efficacy of a single-drop instillation of mitomycin C (MMC) 0.02% after pterygium excision.
- To compare this single-drop method with postoperative and intraoperative MMC application.
- To evaluate recurrence rates and postoperative complications associated with different MMC application strategies.
Main Methods:
- A randomized controlled trial involving 72 patients (80 eyes) with pterygium.
- Four groups were studied: bare scleral excision (BSE) alone (control), BSE with single-drop MMC post-surgery, BSE with daily MMC drops for 5 days post-surgery, and BSE with intraoperative MMC.
- Recurrence rates, scleral defects, wound epithelialization, and ischemic areas were analyzed.
Main Results:
- The single-drop MMC group showed significantly lower recurrence rates (20%) compared to the control group (70%).
- Scleral defects were significantly reduced with the single-drop method (20%) compared to postoperative (80%) and intraoperative (80%) MMC.
- Delayed wound healing and ischemic areas were observed in groups receiving prolonged or intraoperative MMC, but not in the single-drop group.
Conclusions:
- Single-drop instillation of 0.02% mitomycin C following pterygium excision is a safe and effective treatment.
- This method offers comparable efficacy to more intensive MMC regimens with fewer complications.
- The single-drop approach presents a simplified and advantageous option for pterygium surgery.