Recurrence rate with use of intraoperative Mitomycin C versus Conjunctival Autograft following pterygium excision.

Quratulain Paracha

doi:10.12669/pjms.306.5191

Abstract

Objective s : To determine the recurrence rate following Conjunctival Autograft versus Mitomycin C for pterygium excision. Methods: Fifty Patients in this Randomized Clinical Trial who underwent pterygium excision from July 2013 to October 2013 at Department of Ophthalmology, Ziauddin University Hospital, Keamari, Karachi were included. All patients underwent detailed ophthalmic examination before surgery. Few drops of lidocaine were instilled, subconjunctival xylocaine 2% was injected. The pterygium was then excised from bulabar conjunctiva and peeled off from the corneal surface. Mitomycin C was applied to bare sclera in group A and Conjunctival autograft taken from superior bulbar conjunctiva of same eye was sutured to the bare sclera in group B. Data for pterygium recurrence was collected and analyzed using SPSS version 17. Results: Among the 50 patients operated 64% (n=32) were male and 36% (n=18) female. Their age ranged from 28 -58 years with mean age 44.8yrs. Right eye was affected in 54% (n= 27) patients and left in 46% (n= 23). In group “A” (intraoperative MMC) conjunctival granuloma was noted in 1(4%), pterygium recurrence 4(16%) and ocular irritation was experienced by 5 (20%) patients. In group “B” (CAG) graft retraction was seen in 2(8%), patients, 1(4%) patients experienced persistent redness over the grafted tissue and pterygium recurrence was seen in 2(8%) patient. All of them were followed at day 1, week1, week 4 and week 12. Conclusion: Both Conjunctival Autograft and Mitomycin C are effective in reducing the recurrence of pterygium but CAG gives better cosmetic results, the only drawback with it is the duration of the procedure.

Highlights

Pterygium is a conjunctival disorder which usually occurs with increasing age
While pterygium recurrence was observed in 4(16%) patients
This study was carried out to establish a procedure with minimum recurrence and better cosmesis following pterygium excision

Summary

Introduction

Pterygium is a conjunctival disorder which usually occurs with increasing age It arises in the interpalpaberal aperture with nasal aspect of palpaberal conjunctiva affected most frequently. It occurs both on the nasal and temporal aspect simultaneously. It is progressive condition, which often extends to involve peripheral cornea causing astigmatism and at times can block the visual axis. It has reported prevalence of 2% to 7% worldwide.[1] its pathogenesis is not yet clear but ultraviolet radiation is supposed to be the strongest predisposing factor for its development besides hot warm climate, dry eye etc. Excessive outdoor exposure put males more at risk and gender wise it occurs twice as frequently in males than female.[3]

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