role of mitomycin drug in the prevention of pterygium recurrence after surgical removal

This study was carried out on 100 eyes of 100 patients with primary pterygium attending the Outpatient Ophthalmology Clinic of Alexandria University Hospitals. All eyes had their pterygium excised with a standard bare sclera technique and then the eyes were randomized to four groups each comprising 25 eyes. Group A received mitomycin eye drops in a concentration of 0.04% one drop four times daily for 14 days. Group B received mitomycin eye drops 0.02% one drop four times daily for 14 days. Group C received mitomycin eye drops 0.02% one drop twice daily for 5 days and group D received balanced salt solution one drop four times daily for 14 days and this group acted as a control. The eyes were followed up for a maximum of 32 weeks to record differences between the four groups regarding corneal and conjunctival wound healing time, incidence of complications and incidence and timing of recurrence as well as to delineate the statistical significance of any differences obtained with any of the variables studied, in addition to a correlation analysis for the incidence of recurrence versus a number of selected variables. The study showed that there was a statistically significant difference regarding conjunctival wound healing time between the four groups [p = 0.000], incidence of complications by score [p = 0.005] and incidence of recurrence [p = 0.001]. Recurrence was found to correlate significantly only with conjunctival healing time [p = 0.01] with a negative type of correlation. It was shown that the best regimen for topical postoperative application of mitomycin eye drops would be that of 0.02% twice daily for 5 days producing optimal conjunctival healing time, least complications and a fairly very low incidence of recurrence

Immunohistopathological study of pterygium

The pterygial tissue excised from 30 eyes of 30 patients with primary pterygium were subjected to immunohistopathological staining in order to identify the type of antibodies present within such growth. Immunoglobulin E was found in 27 specimens [90%], while immunoglobulin G was found in 23 specimens [76.6%]. From the above findings, it could be assumed that pterygium formation may be a type 1 hypersensitivity reaction. Despite the commonality of pterygium, little is truly known about its etiology. Many theories have been proposed to explain the cause of pterygium, however, most of these theories cannot be reconciled with known facts. It was found that chronic inflammation in the form of conjunctivitis or episcleritis initiates the process. An allergic theory was proposed by Hilgers, while Taylor specifically incriminated exposure to ultraviolet B as the causative factor