TREATMENT OF PRIMARY PTERYGIUM WITH CONJUNCTIVAL AUTOGRAFT AND MITOMYCIN C. A COMPARATIVE STUDY

Abstract

BACKGROUND: Conjunctival autograft and Mitomycin C are two useful adjutants in the prevention of pterygium recurrence. OBJECTIVE: To compare the recurrence rate of conjunctival autograft and Mitomycin C adjuvant in primary pterygium excision. DESIGN: Quasi-experimental study on patients of primary pterygium from November 2004 to November 2006. SETTING: Department of Ophthalmology, Liquat University of Medical and Health Sciences Jamshoro/Hyderabad. METHOD: One hundred cases of primary pterygium were treated with conjunctival autograft and Mitomycin C 0.02% intra-operatively for 5 minutes at the bare sclera by cotton swab. Anesthesia used was topical proparacaine and local infiltration of lignocaine. Patients were followed postoperatively for 9-12 months to find the recurrence (defined as fibrovascular tissues invading the cornea 1mm or more) of pterygium and complications. All surgeries were performed by one surgeon. RESULTS: Of the hundred cases 17 were lost in follow-up. In remaining eighty-three eyes received conjunctival autograft (CAG n=52) and Mitomycin C (MMC n=31). There were 4 (7.69%) recurrences in group A (CAG) and 8 (16.13%) recurrences in group B (MMC). There was statistically significant difference in the recurrence rate between the two groups. The post operative complications in MMC group were two punctate epithelial keratitis, one conjunctival granuloma and one has dellen. No significant complications were encountered in conjunctival autograft group. CONCLUSION: Simple excision of pterygium followed by conjunctival autograft has the lowest recurrence rate and minimal incidence of complications as compared to intraoperative Mitomycin C.