Related Experiment Video
Updated: Jun 28, 2026
In Vitro and In Vivo Models to Study Corneal Endothelial-mesenchymal Transition
Published on: August 20, 2016
The effect of mitomycin C on corneal endothelium in pterygium surgery
Irit Bahar1, Igor Kaiserman, Alex P Lange
1Ophthalmology Department, Toronto Western Hospital, University of Toronto, Ontario, Canada. iritbahar@yahoo.com
Purpose:
To evaluate the changes in endothelial cell counts in patients after pterygium surgery with mitomycin C (MMC) 0.02% and to compare them with patients undergoing pterygium excision without MMC.
Design:
Prospective nonrandomized study.
Methods:
Forty-three consecutive patients were included in this study. Sixteen patients underwent pterygium surgery with conjunctival autograft and MMC for recurrent pterygium and 27 patients underwent pterygium excision without MMC for primary pterygium removal (control group) at the Toronto Western Hospital. Endothelial images were acquired at the center of the cornea with a specular microscope before surgery and at one week, one month, and three months following surgery.
Results:
Mean preoperative endothelial cell counts were 2330 +/- 318 cells/mm(2) in the pterygium excision without MMC group and 2486 +/- 327 cells/mm(2) in the pterygium excision with MMC group (P = .13). One month after surgery, the pterygium with MMC group showed a significant endothelial cell loss of 6% which was not present in the control group (P = .03). Three months after surgery, endothelial cell loss was reduced to 4%. (P = .08 compared with the control). In the pterygium excision with MMC group, endothelial polymeghatism was increased (at one and three months) and the percentage of hexagomal cells was reduced (at one month).
Conclusions:
The use of topical MMC during recurrent pterygium surgery was found to have a deleterious effect on corneal endothelium one month following surgery. Judicious use of this drug is therefore recommended.
Insights
Topical mitomycin C (MMC) used in pterygium surgery can cause significant endothelial cell loss in the cornea, particularly one month post-operation. Careful consideration of MMC use is advised for pterygium treatment.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ocular Pharmacology
Background:
- Pterygium is a common ocular condition.
- Surgical excision is the primary treatment for pterygium.
- Mitomycin C (MMC) is sometimes used to prevent recurrence.
Purpose of the Study:
- To evaluate corneal endothelial cell changes after pterygium surgery with 0.02% mitomycin C (MMC).
- To compare these changes with pterygium excision performed without MMC.
Main Methods:
- Prospective nonrandomized study involving 43 patients.
- 16 patients had recurrent pterygium surgery with MMC and conjunctival autograft.
- 27 patients had primary pterygium excision without MMC (control group).
- Specular microscopy assessed endothelial cell counts pre-surgery and at 1 week, 1 month, and 3 months post-surgery.
Main Results:
- Preoperative endothelial cell counts were similar between groups.
- One month post-surgery, the MMC group showed a significant 6% endothelial cell loss (P=.03).
- This loss reduced to 4% by three months (P=.08 vs. control).
- Increased endothelial polymegethism and reduced hexagonal cells were noted in the MMC group.
Conclusions:
- Topical MMC during recurrent pterygium surgery has a detrimental effect on corneal endothelium.
- Judicious use of MMC in pterygium surgery is recommended.
