A comparative study of recurrent pterygium surgery: Limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap

Abstract

Objective To compare the recurrence rate following treatment of recurrent pterygia using one of two techniques—limbal conjunctival autograft transplantation versus low-dose intraoperative mitomycin C (0.2 mg/ml) combined with conjunctival flap closure. Design Randomized clinical trial. Participants Eighty-one patients with recurrent pterygia treated by limbal conjunctival autograft transplantation ( n= 41) or mitomycin C combined with conjunctival flap ( n= 40) participated. Intervention Limbal conjunctival autograft transplantation or low-dose intraoperative mitomycin C application with conjunctival flap technique was performed on recurrent pterygium cases. Main outcome measures Recurrence of pterygium and postoperative complications. Results During mean follow-up periods of 16±1.9 and 15.5±1.5 months, six recurrences (14.6%) in the limbal conjunctival autograft transplantation group and five recurrences (12.5%) in the mitomycin C group were observed ( P=0.77). The difference between the mean ages of recurrent (26.4±8.0 years) and nonrecurrent (35.8±11.9 years) cases for all patients was statistically significant ( P=0.014). Technically, limbal conjunctival autograft transplantation seemed to be more difficult. The most frequent complication in limbal conjunctival autograft transplantation was graft edema, whereas that in the mitomycin C group was superficial keratitis. Conclusion Both techniques showed similar recurrence rates in the treatment of recurrent pterygia. Although technically easier to perform, further follow-up is necessary to determine the long-term safety of low-dose intraoperative mitomycin C with conjunctival flap closure. The surgeon’s familiarity with either procedure should determine the method of choice.