Single intraoperative application versus postoperative mitomycin C eye drops in pterygium surgery

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Pterygium recurrence after surgery remains a clinical challenge.
• Mitomycin C (MMC) has shown potential in preventing post-surgical pterygium regrowth.

Purpose of the Study:

• To evaluate the optimal dosage, administration route, and long-term outcomes of mitomycin C for pterygium surgery recurrence prevention.
• To compare different concentrations and application methods of MMC against a control group.

Main Methods:

• A prospective, masked study involving 227 patients undergoing primary pterygium surgery.
• Patients were randomized into five groups: intraoperative MMC (0.2 or 0.4 mg/ml for 3 minutes) or topical MMC eye drops (0.2 or 0.4 mg/ml for 7 or 14 days), plus a control group (surgery alone).

Main Results:

• Mitomycin C significantly reduced pterygium recurrence rates compared to surgery alone (P < 0.001).
• Recurrence rates were 6.66% (0.2 mg/ml intraop), 4.08% (0.4 mg/ml intraop), 4.26% (0.2 mg/ml drops), 4.44% (0.4 mg/ml drops), versus 29.27% for the control group.
• No significant differences in efficacy were found among the different MMC treatment groups (P > 0.0681), and no therapy-related complications were observed.

Conclusions:

• A single, low-concentration, intraoperative application of mitomycin C is effective and safe for preventing pterygium recurrence.
• This approach, when used with a conjunctival flap and minimal scleral cauterization, offers a superior alternative to surgery alone.