Comparative Assessment of Mitomycin C versus Limbal Conjunctival Autograft for Primary Pterygium Removal: An Evaluation of Efficacy

Abstract

Objective: This study aims to evaluate and contrast the outcomes achieved by application of mitomycin C 0.02% intra-operatively versus employing limbal conjunctival autograft after the removal of primary pterygium. Study Design: Randomized controlled trial (RCT) Place and duration: The research was carried out at the Ophthalmology Department of Ghazi Hospital in Dera Ghazi Khan, spanning from October 2021 to September 2022. Methodology: The research included 62 participants who were divided into two groups; one group receiving Mitomycin C and the other group underwent limbal conjunctival autograft. The main variables assessed in the study were the laterality of pterygium, size of pterygium extending over the limbus, preoperative and postoperative best corrected visual acuity, and the rate of pterygium recurrence in both groups. The analysis of data was conducted utilizing SPSS version 24. Results: In Group MMC, 48.4% of patients showed right laterality, while in Group LCAU, 58.1% (p=0.445) showed it. The average size of pterygium crossing the limbus, as well as preoperative and postoperative best corrected visual acuity, were similar between both groups (p>0.050). Regarding recurrences, the percentages at 3, 6, and 9 months, as well as after 1 year, were higher in Group MMC (12.9%, 6.5%, 16.1%, 9.7%, 45.2%) compared to Group LCAU (9.7%, 9.7%, 3.2%, 6.5%, 29%), but these differences were not statistically significant (p=0.526). Conclusion: Limbal conjunctival autograft appears to be more effective in preventing recurrence following the excision of primary pterygium compared to intraoperative application of Mitomycin C. However, both techniques, whether simple excision with LCAU or MMC application, demonstrate acceptable outcomes with only minor differences in recurrence rates. Surgeon expertise and preferences in local practice play significant roles as main risk factors influencing the choice between these two methods.