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Intraoperative mitomycin in primary pterygium excision. A prospective, randomized trial
C A Manning1, P M Kloess, M D Diaz
1Wilford Hall Medical Center, San Antonio, Texas, USA.
Ophthalmology
|May 1, 1997
Summary
Intraoperative mitomycin application for pterygium treatment resulted in the lowest recurrence rate compared to conjunctival autografts and postoperative mitomycin. This method offers an effective, safe alternative for reducing pterygium regrowth.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Pharmacology
Background:
- Pterygium recurrence is high after simple excision.
- Conjunctival autografting and postoperative mitomycin are established adjuvant therapies.
- Newer methods aim to improve recurrence rates and reduce complications.
Purpose of the Study:
- To compare conjunctival autograft, postoperative mitomycin, and intraoperative mitomycin for pterygium treatment.
- To evaluate recurrence rates and complications associated with each method.
- To determine the efficacy of intraoperative mitomycin application.
Main Methods:
- Prospective, randomized study involving 50 patients with 56 primary pterygia.
- Three treatment groups: conjunctival autograft, postoperative mitomycin (0.2 mg/ml), and intraoperative mitomycin (0.4 mg/ml).
- Mean follow-up of 16 months.
Main Results:
- Recurrence rates: 22.2% (autograft), 21.1% (postoperative mitomycin), 10.5% (intraoperative mitomycin).
- Complications occurred in the postoperative mitomycin group (scleral thinning, epithelial toxicity).
- No complications were reported in the autograft or intraoperative mitomycin groups.
Conclusions:
- Intraoperative mitomycin application is a safe and effective alternative to postoperative mitomycin therapy.
- Intraoperative mitomycin demonstrated the lowest pterygium recurrence rate in this study.
- The study recommends intraoperative mitomycin over postoperative administration for adjunctive therapy.