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Preoperative Versus Intraoperative Subpterygial Mitomycin C Injection for Prevention of Pterygium Recurrence
Sameh Saad Mandour1, Hatem M Marey1, Hassan G Farahat1
1Department of Ophthalmology, Menoufia Faculty of Medicine , Shebin El Kom, Egypt .
Purpose:
To evaluate postoperative outcome and recurrence rate after primary pterygium excision using preoperative versus intraoperative subpterygial Mitomycin C (MMC) injection.
Methods:
Eighty-three eyes with primary pterygium were divided into 2 groups. Group A (35 eyes) was operated upon with pterygium excision 5 min after subpterygial injection of 0.1 mL 0.015% MMC in the same operative setting. Group B (48 eyes) was operated upon with pterygium excision 1 month after subpterygial injection of the same amount and concentration of MMC as in group A. Pterygium regrowth over the cornea for 1 mm or more was considered as a recurrence.
Results:
The mean follow-up was 30.66±4.48 months in group A and 29.5±4.3 months in group B. In group A, the reported recurrence rate was 5.7%, while it was 4.2% in group B. No serious postoperative complications were reported. There was no statistically significant difference between both groups regarding the recurrence rate as well as the complication rate.
Conclusion:
Both techniques proved to be effective in reducing the recurrence rate after excision of primary nasal pterygium with minimal postoperative complications, with no need of a second surgery for patients in group A.
Insights
Both preoperative and intraoperative subpterygial Mitomycin C (MMC) injections effectively reduce pterygium recurrence after excision. No significant differences in recurrence or complications were observed between the two timing methods for MMC delivery.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Pharmacology
Background:
- Pterygium excision is a common ophthalmic procedure.
- Recurrence after pterygium surgery remains a clinical challenge.
- Mitomycin C (MMC) is an antimetabolite used to inhibit fibroblast proliferation and reduce recurrence.
Purpose of the Study:
- To compare the efficacy of preoperative versus intraoperative subpterygial Mitomycin C (MMC) injection in reducing recurrence rates after primary pterygium excision.
- To evaluate and compare postoperative outcomes and complication rates between the two MMC administration timings.
Main Methods:
- Eighty-three eyes with primary pterygium were divided into two groups.
- Group A: Pterygium excision 5 minutes after subpterygial MMC injection (intraoperative).
- Group B: Pterygium excision 1 month after subpterygial MMC injection (preoperative). Recurrence defined as pterygium regrowth ≥1 mm onto the cornea.
Main Results:
- Mean follow-up was approximately 30 months for both groups.
- Recurrence rates were 5.7% in Group A and 4.2% in Group B.
- No statistically significant difference in recurrence or complication rates between the intraoperative and preoperative MMC groups.
Conclusions:
- Both preoperative and intraoperative subpterygial MMC injections are effective in reducing primary nasal pterygium recurrence.
- Both methods demonstrate minimal postoperative complications.
- The intraoperative MMC injection technique eliminates the need for a second surgery.
