The Effectiveness of Mitomycin C on Pterygium Surgery with Amniotic Membrane Transplantation

PURPOSE: To compare postoperative recurrence rates of pterygium surgery with amniotic membrane transplantation with and without mitomycin C. METHODS: A retrospective analysis of 45 eyes of 43 patients who underwent pterygium surgery with amniotic membrane transplantation with a minimum of six months of follow-up. Nineteen eyes underwent mitomycin C application, while the remaining 26 eyes did not. Recurrence rates and complications were evaluated. RESULTS: With a minimum of six months of follow-up, fibrovascular tissue in the excised area not invading the cornea (conjunctival recurrence) was noted in two eyes (10.5%), and fibrovascular tissue invading the cornea (corneal recurrence) was noted in one eye (5.4%) in the amniotic membrane transplantation with mitomycin C group. Conjunctival recurrence was noted in six eyes (23.1%) and corneal recurrence in three eyes (11.5%) in the amniotic membrane transplantation without mitomycin C group. Recurrence rate in the amniotic membrane transplantation with mitomycin C group (15.9%) was significantly lower (p = 0.014) than that in the amniotic membrane transplantation without mitomycin C group (34.6%). Complications included sub-amniotic membrane hemorrhage in two eyes, granuloma in one eye, and wound dehiscence in one eye in each group. There were no specific complications related to usage of mitomycin C. CONCLUSIONS: In pterygium surgery with amniotic membrane transplantation, application of mitomycin C is an effective method to reduce recurrence rates, especially conjunctival recurrences that are related to cosmetic problems. This method may also be helpful to reduce patient discomfort.

Effectiveness of Wide Excision of Subconjucntival Fibrovascular Tissue with Conjunctivo-Limbal Autograft in Pterygium Surgery

PURPOSE: To evaluate the efficacy of wide excision of subconjucntival fibrovascular tissue after conjunctivo-limbal autograft of primary and recurrent pterygium. METHODS: Sixty-five eyes of 59 patients underwent pterygium excision with conjunctivo-limbal autograft. Thirty-six eyes of 33 patients had wide excision of pterygium, 29 eyes of 26 patients did not have wide excision of pterygium. All patients underwent follow-up for more than one year. Complications, recurrence rate, and operation time were evaluated. RESULTS: With a minimum of one year of follow-up, there was no recurrence in either group. Six cases (17%) of subconjunctival fibrosis at the donor site, one case (3%) of subconjunctival neovascularization at the donor site, and one case (3%) of wound gapping at the recipient site were noted in the wide excision group. In the non-wide excision group, there were two cases (7%) of subconjunctival fibrosis at the donor site, one case (3%) of granuloma at the donor site, and one case (3%) of retention cyst at the recipient site. Mean operating time in the non-wide excision group (45.2 +/- 6.9 minutes) was significantly shorter than that in the wide excision group (62.4 +/- 6.2 minutes). CONCLUSIONS: Non-wide excision with conjunctivo-limbal autograft in pterygium surgery can be considered an effective treatment with shorter operating time than the wide excision method. Both of these methods show low recurrence rates and few complications for both primary and recurrent pterygia.