Pterygium surgery with mitomycin and tarsorrhaphy

Area of Science:

• Ophthalmology
• Surgical Innovation
• Ocular Surface Disease

Background:

• Pterygium, a common ocular condition, often recurs after surgical removal.
• Existing surgical techniques have varying recurrence rates and potential complications.
• Conjunctival transplantation is sometimes used to reduce recurrence but adds complexity.

Purpose of the Study:

• To evaluate a simplified pterygium surgical procedure incorporating mitomycin and temporary tarsorrhaphy.
• To assess the safety, efficacy, and recurrence rates of this novel technique.
• To determine if this method reduces the need for conjunctival transplantation.

Main Methods:

• A cohort of 20 eyes received pterygium excision with mitomycin (0.25 mg/mL for 1 minute) and temporary nasal tarsorrhaphy.
• A control group of 28 eyes underwent pterygium surgery without mitomycin.
• Both groups received postoperative dexamethasone/antibiotic drops; follow-up averaged 12.1 months (mitomycin) and 42.6 months (control).

Main Results:

• The mitomycin group had zero recurrences, significantly lower than the 32% recurrence rate in the non-mitomycin group (P = .006).
• Conjunctival healing was significantly delayed in the mitomycin group (36.7 days vs. 17 days, P = .001).
• No major complications directly attributed to mitomycin were reported, though delayed healing was noted.

Conclusions:

• The described pterygium surgical technique, including minimal conjunctival removal, mitomycin application, and tarsorrhaphy, is safe and effective.
• This approach significantly reduces pterygium recurrence rates.
• The method simplifies pterygium management and may lessen the need for conjunctival grafts.