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Recurrence Rate and Clinical Outcome of Amniotic Membrane Transplantation Combined with Mitomycin C in Pterygium
Hasan Razmjoo1, Seyed-Abolfazl Kashfi1, Majid Mirmohammadkhani2,3
1Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Objective:
To evaluate the recurrence rate and outcome of pterygium surgery with amniotic membrane transplantation (AMT) and intraoperative mitomycin C (MMC).
Methods:
This prospective clinical study included patients with pterygium who were candidates for pterygium excision. After the surgical excision, intraoperative local MMC were applied in the standard protocol followed by AMT. The outcome measures were recurrence and the size change of lesion. Kaplan-Meier estimation and regression analyses were performed.
Findings:
Fifty five eyes of 55 consecutive patients including 30 male (54.5%) and 25 female (45.5%) with mean age of 47.12 ± 15.95 years were operated. The mean follow-up period was 15.21 ± 2.67 months. The overall recurrence rate was 34.5% (19/55 cases). The estimated recurrence time for larger size of pterygium before surgery was short and marginally significant (17.14 ± 0.58 month in size of ≤3.0 mm versus. 18.56 ± 0.60 month in size of <3 mm; P= 0.06). A statistically significant association was found in reduced model among the size change of the pterygium and standardized coefficient was -0.012 (P = 0.044) and -0.743 (P < 0.001) for age and size of lesion before surgery, respectively.
Conclusion:
Our findings suggest that increasing age and pterygial tissue are the risk factors for recurrence and pterygium has a substantial recurrence rate even after AMT combined with MMC.
Insights
Pterygium surgery using amniotic membrane transplantation (AMT) and mitomycin C (MMC) shows a 34.5% recurrence rate. Increasing age and pterygium size are risk factors for recurrence, even with combined treatments.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Clinical Research
Background:
- Pterygium, a common ocular condition, often recurs after surgical excision.
- Standard surgical techniques combined with adjunctive therapies aim to minimize recurrence.
- Amniotic membrane transplantation (AMT) and intraoperative mitomycin C (MMC) are utilized to improve surgical outcomes.
Purpose of the Study:
- To assess the recurrence rate and clinical outcomes of pterygium excision utilizing amniotic membrane transplantation (AMT) and intraoperative mitomycin C (MMC).
Main Methods:
- A prospective clinical study involving patients undergoing pterygium excision.
- Application of intraoperative mitomycin C (MMC) followed by amniotic membrane transplantation (AMT).
- Outcome measures included pterygium recurrence and lesion size change, analyzed using Kaplan-Meier estimation and regression analyses.
Main Results:
- The study included 55 patients (30 male, 25 female) with a mean age of 47.12 years.
- The overall pterygium recurrence rate was 34.5% after a mean follow-up of 15.21 months.
- Increased patient age and larger pterygium size pre-surgery were significantly associated with higher recurrence rates.
Conclusions:
- Pterygium recurrence remains substantial even with the combined use of AMT and MMC.
- Patient age and the size of the pterygial tissue are identified as significant risk factors for post-operative recurrence.
- Further research may be needed to optimize strategies for reducing pterygium recurrence.
