Effects of tear film after conjunctival autograft transplant and limbal conjunctival autograft transplant for primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the effects of tear film after conjunctival autograft transplant(CAT)and limbal conjunctival autograft transplant(LCAT)for primary pterygium.<p>METHODS: In a prospective study, 150 patients(150 eyes)diagnosed with primary pterygium were collected in Beijing road medical area of Xinjiang Military Region General Hospital from September 2018 to May 2019. The 150 patients enrolled in the study in turn, and divided into two groups by the odd and even number. The odd number underwent CAT and the even number underwent LCAT. Respectively before surgery and 1, 3, 6mo and 1a after surgery, tear film break-up time(TBUT), SchirmerⅠtest(SⅠt)and ocular surface disease index(OSDI)were checked. The date were compared and analyzed.<p>RESULTS:Totally 129 patients(129 eyes)completed the follow-up of 1a, including 64 patients(64 eyes)from the CAT group and 65 patients(65 eyes)from the LCAT group. Four patients(4 eyes, recurrence rate 6.2%)in the CAT group and 3 patients(3 eyes, recurrence rate 4.6%)in the LCAT group developed recurrence. However, there was no significant in recurrence rate between CAT group and LCAT group(<i>P</i>=0.718). There were significant differences between before surgery and after surgery in each group(<i>P</i><0.05), and there were significant differences between 1mo after surgery and 3, 6mo and 1a after surgery in each group(<i>P</i><0.05), while there was no significant different among 3, 6mo and 1a after surgery in each group in TBUT, SⅠt and OSDI(<i>P</i>>0.05). Also there was no significant different between CAT group and LACT group in each time in TBUT, SⅠt and OSDI(<i>P</i>>0.05).<p>CONCLUSION:Both CAT and LCAT could effectively treat primary pterygium with low and similar recurrence rate, and the degree of improvement of tear film after primary pterygium operation is similar between the two surgical methods.

Differences in clinical characteristics and laboratory parameters of primary and recurrent pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#Pterygium is a common conjunctival disease which is mainly attributed to chronic ultraviolet light exposure. Previous studies have focused primarily on the clinical characteristics, surgical management and the pathogenesis of pterygium, but the differences between primary pterygium and recurrent pterygium have been less frequently documented. This article reviews the differences in clinical manifestations, histopathological findings, and laboratory parameters between primary pterygium and recurrent pterygium and summarises the latest findings regarding these differences.

Comparison of fibrin glue and sutureless autologous conjunctival flap fixation in the treatment of pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the outcome in terms of patients comfort, graft stability, graft inflammation, recurrence and other postoperative complications between the two sizes of conjunctivolimbal autograft used in fibrin glue and suture less glue free methods of conjunctivolimbal autograft fixation for primary pterygium surgery.<p>METHODS: This was a prospective interventional comparative study conducted on 80 patients(80 eyes)with pterygium from December 2014 to August 2016. The study group was randomly selected and divided into two groups, <i>i.e.</i> people underwent fibrin glue was group 1, and those underwent suture less glue free methods of autograft fixation was group 2. For each group equal numbers of subjects were enrolled and further each group was divided into two more groups(groups A and B in group 1, groups C and D in group 2)by random selection. Group A(size of autograft same as bare sclera)and group B(size 1 mm larger than bare sclera)received fibrin glue technique; and group C(size of autograft same as bare sclera)and group D(size 1 mm larger than bare sclera)received suture less glue free technique of conjunctival autograft fixation. Each patient underwent pterygium excision with size of conjunctival autograft used as per the respective group. Follow up visits were scheduled at 1d, 1wk, 6wk, 6mo and 1y postoperatively.<p>RESULTS: Mean age of the patients in group 1(Fibrin glue group)was 43.525 years old and in group 2(suture less glue free group)was 42.2 years old. Females were 60 and males were 20. All the 37 patients had pterygium in RE. Average surgical time was similar in all the four groups. Postoperative parameters like patient comfort, graft retraction, graft inflammation and graft edema were similar in all the four groups during every postoperative follow-up visits except for subconjunctival haemorrhage which was significantly more in fibrin glue group until first postoperative week(<i>P</i><0.0001). Grade 4 graft retraction/displacement was observed in only three patients from group 2. At 1wk postoperative, graft cyst was observed in two patients(one in group A and one in group D). Recurrence was observed in two patients(in group D)at 6mo follow-up.<p>CONCLUSION: Both methods are safe and effective for graft adhesion with less postoperative discomfort and complications. Compared to fibrin glue method, suture less and glue free method is very economical and outcome in this method is comparable to fibrin glue group. Since this procedure is cost effective and also have all the advantages of fibrin glue, suture less glue free method can be considered as very effective method in treating patients.

Expressions of Bcl-2, Bax and Ki67 in the primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To research the expressions of B-cell lymphoma gene 2 (Bcl-2), Bcl-2 associated X-protein (Bax) and Ki67 (proliferating cell marker) in the primary pterygium and normal bulbar conjunctiva, to explore the pathogenesis of pterygium. METHODS: Thirty pterygium were surgically removed and 5 normal bulbar conjunctivas were also obtained. Formalin-fixed, paraffin-wax-embedded tissues were analyzed by immunohistochemistry with Bcl - 2, Bax, Ki67. RESULTS:The mean positive expression of Bcl-2, Bax and Ki67 in the primary pterygium was 14.73%, 7.00% and 12.73%, respectively 4.00%,6.00% and 0 in normal conjunctiva group. The expression of Bcl-2 and Ki67 in the head of primary pterygium was higher than that of neck and body. CONCLUSION: Bcl-2 and Ki67 have highly expressions in the primary pterygium, the expressions in the head of primary pterygium is the highest, the expressions in normal bulbar conjunctiva is low or no. There is no significant difference in the expression of Bax in the primary pterygium and normal bulbar conjunctiva. Apoptosis imbalance and abnormal proliferation of cells may be one of the mechanisms for the occurrence and development of the primary pterygium.

Clinical effect of limbal conjunctival autograft or amniotic membrane transplantation for the treatment of primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To observe the clinical effect of limbal conjunctival autograft transplantation (LCAT) or amniotic membrane transplantation ( AMT ) in treatment of primary pterygium. ·METHODS:Analysis of 96 cases(96 eyes) with primary pterygium treated at Shenzhen People's Hospital from January 2013 to December 2015 was taken. Depending on the surgical methods, the patients were divided into two groups: excision of pterygium and limbal conjunctival autograft transplantation being performed in LCAT group (46 cases,46 eyes); excision of pterygium and amniotic membrane transplantation being performed in AMT group (50 cases, 50 eyes). Two groups were followed-up for 12mo to compare the operation time, the corneal epithelium repair time, postoperative complications and the recurrence rate. ·RESULTS:The operation time of LCAT and AMT group was 33. 83 ± 1. 65min, 23. 60 ± 1. 51min respectively, the LCAT group was higher than the AMT group (t=-31.683, P<0.001). The corneal epithelium repair time of LCAT and AMT group was 4.04±0.95d,4.67±1.18d respectively, the LCAT group was lower than the AMT group (t=-2.922,P=0.004); 1 case was recurred in LCAT group, 3 cases were recurred in AMT group. The recurrence rate was 2% in LCAT group and 6% in AMT group, but it hadn't show a significant statistical difference between the two groups (P = 0. 618). One case of conjunctival granuloma was observed in 2wk after surgery of LCAT group, but no serious complications were observed in AMT group. · CONCLUSION: Limbal conjunctival autograft transplantation and amniotic membrane transplantation are effective and safe methods to primary pterygium, which have advantages of rapid recovery, fewer complications and the lower recurrence rate.

TNF-α and IFN-γin tear of patients with primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the roles of tumor necrosis factor alpha ( TNF-α) , interferon gamma ( IFN-γ) in pathogenesis of primary pterygium and to explore the mechanism of tears in pterygium.?METHODS: Concentrations of TNF-α and interferon gamma IFN - γ were quantified by enzyme - linked immunosorbent assay ( ELISA ) in asymptomatic control group (30 eyes of 30 healthy volunteers) and 60 primary pterygium patients ( 30 eyes of the 30 progressive cases, 30 eyes of the 30 quiescent cases) . The data was analyzed by analysis of variance.?RESULTS:The concentration of TNF-αand IFN-γin the patients with primary pterygium were statistically significant (P<0. 05), compared with the normal control group. Tear concentration of TNF-α was significantly higher in primary pterygium compared with the control group. Tear concentration of IFN - γ was significantly reduced in primary pterygium compared with the control group (P<0. 05).?CONCLUSION:TNF-α and IFN-γmay be important in the pathogenesis and development of pterygium tissues.It can provide some new directions and ideas for the treatment of primary pterygium.

A Comparative Study of Topical Mitomycin C, Cyclosporine, and Bevacizumab after Primary Pterygium Surgery

PURPOSE: To compare the recurrence rates and complications associated with instillation of topical mitomycin C, cyclosporine, and bevacizumab after primary pterygium surgery. METHODS: Between July 2013 and June 2014, we performed surgery using the bare sclera method on 132 eyes (132 patients) with primary pterygium. We randomly selected 33 eyes (33 patients) and treated them with artificial tears four times a day for three months, 29 eyes (29 patients) were treated with topical 0.02% mitomycin C four times a day for five days, 34 eyes (34 patients) were treated with topical 0.05% cyclosporine four times a day for three months, and 36 eyes (36 patients) were treated with topical 2.5% bevacizumab four times a day for three months after surgery. We prospectively determined the recurrence rates of pterygium and complications at the six-month follow-up examination. RESULTS: At six months after surgery, the recurrence rates in each group were as follows: 45.5% (15 eyes) in the control group, 10.3% (three eyes) in the mitomycin C group, 20.6% (seven eyes) in the cyclosporine group, and 41.7% (15 eyes) in the bevacizumab group (p = 0.004). No serious complications, except subconjunctival hemorrhages, were observed in any group. CONCLUSIONS: Groups receiving topical 0.02% mitomycin C and 0.05% cyclosporine after surgery showed lower recurrence rates than the control group; however, no difference in recurrence rate was observed between the control group and the group receiving topical 2.5% bevacizumab after surgery.

Comparison of conjunctival graft thickness after primary and recurrent pterygium surgery: Anterior segment optical coherence tomography study.

Objective: The objective of the following study is to compare the conjunctival graft thickness measured with anterior segment optical coherence tomography (OCT) after primary and recurrent pterygium excision. Design: Prospective, interventional and comparative study. Participants: A total of 20 eyes of 20 patients with primary pterygium (primary group) and 20 eyes of 20 patients with recurrent pterygium (recurrent group) were enrolled. Materials and Methods: All patients underwent pterygium excision with conjunctival autograft transplantation. Conjunctival graft thickness was measured at 1 week, 1 month and 3 months after surgery using the Visante‑OCT (Carl‑Zeiss Meditec, Dublin, CA, USA). Main outcome measure was the mean conjunctival thickness determined as the mean of three measurements at 1, 2 and 3 mm posterior to the scleral spur. Results: There were no statistically significant differences in age, sex, or laterality between the groups. Mean thickness of the graft in primary and recurrent groups, respectively, was 430 ± 127 μm and 461 ± 178 μm at 1 week after surgery (P = 0.587), 114 ± 19 μm and 162 ± 48 μm at 1 month after surgery (P = 0.001) and 109 ± 15 μm and 107 ± 18 μm at 3 months after surgery (P = 0.726). Conclusion: The findings revealed that conjunctival thickness after primary or recurrent pterygium excision was greatest at 1 week after surgery and continued to decrease for up to 3 months. Mean graft thickness differed significantly between the two groups only at 1 month after surgery.

Comparison of conjunctival graft thickness after primary and recurrent pterygium surgery: Anterior segment optical coherence tomography study.

Objective: The objective of the following study is to compare the conjunctival graft thickness measured with anterior segment optical coherence tomography (OCT) after primary and recurrent pterygium excision. Design: Prospective, interventional and comparative study. Participants: A total of 20 eyes of 20 patients with primary pterygium (primary group) and 20 eyes of 20 patients with recurrent pterygium (recurrent group) were enrolled. Materials and Methods: All patients underwent pterygium excision with conjunctival autograft transplantation. Conjunctival graft thickness was measured at 1 week, 1 month and 3 months after surgery using the Visante‑OCT (Carl‑Zeiss Meditec, Dublin, CA, USA). Main outcome measure was the mean conjunctival thickness determined as the mean of three measurements at 1, 2 and 3 mm posterior to the scleral spur. Results: There were no statistically significant differences in age, sex, or laterality between the groups. Mean thickness of the graft in primary and recurrent groups, respectively, was 430 ± 127 μm and 461 ± 178 μm at 1 week after surgery (P = 0.587), 114 ± 19 μm and 162 ± 48 μm at 1 month after surgery (P = 0.001) and 109 ± 15 μm and 107 ± 18 μm at 3 months after surgery (P = 0.726). Conclusion: The findings revealed that conjunctival thickness after primary or recurrent pterygium excision was greatest at 1 week after surgery and continued to decrease for up to 3 months. Mean graft thickness differed significantly between the two groups only at 1 month after surgery.

Caracterización clínico- epidemiológica del pterigium primario. Área de salud andrés eloy blanco, Venezuela / Clinical-epidemic characterization of the primary pterygium. Area of health andrés eloy blanco, Venezuela

Introducción: entre las enfermedades que limitan el perfecto funcionamiento del sistema visual se encuentra el pterigium que ya, desde épocas históricas remotas como la de los textos hipocráticos, aparece descrito como la invasión conjuntival de la córnea. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con pterigium primario en el área de salud Andrés Eloy Blanco. Material y métodos: se realizó un estudio observacional, descriptivo de corte transversal en el municipio Barquisimeto, Estado Lara, Venezuela, en el período de septiembre a diciembre de 2007. El universo de estudio estuvo constituido por los 1 580 pacientes pesquisados con la enfermedad y la muestra por 320 pacientes después de aplicados los criterios de inclusión y exclusión. Se analizaron las variables edad, sexo, color de la piel, ocupación, síntomas, ojo afectado, localización y grado de la lesión. Resultados: se encontró la mayor frecuencia de pacientes entre 30 y 39 años (29,69%), del sexo masculino (55,31%), color de piel mestiza (77,5%) y con ocupación de riesgo (77,19%). Predominaron los casos sintomáticos (87,19%), mayor afectación del ojo derecho (50,0%), localización nasal (67,29%) y la lesión grado I (60,05%). El grupo de edades comprendido entre 30 y 49 años fue el más afectado. Conclusiones: predominaron el sexo masculino, la piel mestiza, las ocupaciones consideradas de riesgo, el pterigium sintomático, los síntomas de enrojecimiento, sensación de cuerpo extraño y ardor, la afectación unilateral, del ojo derecho y la localización nasal. El grado I fue el más encontrado, seguido de los grados II y III.

Introduction: between the illnesses that limit the perfect functioning of the visual system there is the pterigyum that already, from remote historical epochs as that of the Hippocratic's texts, turns out to be described as the conjunctivae invasion of the cornea. Objective: to characterize clinic and epidemiological the patients with pterigyum primarily in the field of health Andrés Eloy Blanco. Material and methods: it was carried out an observational study, descriptive of traverse court study with the objective of characterizing clinical and epidemically to the patients with primary pterygium in the area of health Andrés Eloy Blanco, municipality Barquisimeto, state Lara, Venezuela, in the period of September to December of 2007. The study universe was constituted by the 1580 patient with the illness and the sample for 320 patients after having applied the inclusion and exclusion approaches. The variables age, sex, color of the skin, occupation, symptoms, affected eye, localization and degree of the lesion were analyzed. Results: it was the biggest frequency of patients between 30 and 39 years (29,69%), of the masculine sex (55,31%), non-white color of skin (77,5%) and with occupation of risk (77,19%). The symptomatic cases prevailed (87,19%), bigger affectation of the right eye (50,0%), nasal localization (67,29%) and the lesion degree I (60,05%). The group of ages understood between 30 and 49 years was the most affected. Conclusions: prevailed the masculine sex, non-white color skin, the considered occupations of risk, the symptomatic pterygium, the symptoms redness, sensation of strange body and ardor, the unilateral affectation, of the right eye and the nasal localization. The degree I was the most opposing, followed by the degrees II and III.

The Effect of Subconjunctival Bevacizumab Injection after Primary Pterygium Surgery

PURPOSE: To evaluate the effect and safety of subconjunctival bevacizumab injection immediately after primary pterygium surgery. METHODS: From October 2010 to June 2011, 54 patients (54 eyes) with primary pterygium who had received pterygium excision with the bare sclera technique were evaluated. Twenty-seven patients (27 eyes) in the bevacizumab group received a subconjunctival injection of 5 mg (0.2 ml) bevacizumab and 27 patients (27 eyes) in the control group received a subconjunctival injection of 0.2 ml balanced salt solution immediately after surgery. At the 6-month follow-up, the degree of fibrovascular tissue proliferation, the recurrence rate of pterygium and the effect of wound healing were analyzed prospectively. RESULTS: One month after the surgery, the degree of fibrovascular tissue proliferation was inhibited in the bevacizumab group compared to the control group (p = 0.028). However, 3 to 6 months after surgery, there was no significant difference between the 2 groups. In addition, there was no significant difference between the 2 groups in the recurrence rate of pterygium and wound healing after surgery. CONCLUSIONS: Subconjunctival bevacizumab injection after primary pterygium surgery inhibited the degree of fibrovascular tissue proliferation for 1 month and safe for wound healing. Subconjunctival bevacizumab injection has the potential for adjunctive therapy after pterygium surgery.

Effects of Temporary Amniotic Membrane Patch after Surgical Excision of Primary Pterygium

PURPOSE: To investigate the clinical results, recurrence rates, and recurrence-related risk factors of temporary amniotic membrane patch (TAMP) after excision of primary pterygium. METHODS: Recurrence grade was evaluated for 73 eyes with a mean follow-up of 15.5 months (range 9 to 56 months). Surgical results were classified into surgical success (G0/G1), conjunctival recurrence (G2), and corneal recurrence (G3). Recurrence rates were analyzed based on gender, age, Tan's preoperative grading system, horizontal and vertical length of the preoperative pterygium, the corneal involvement size of the preoperative pterygium, planned or unplanned removal of amniotic membrane, and epithelial healing time. Using Kaplan-Meier survival analysis, the cumulative proportion of integrated G0/G1 was evaluated. RESULTS: In the postoperative grading, 58 (79.5%) and 9 (12.3%) eyes were graded as clinically recurrence-free G0 and G1, respectively; 4 (5.5%) and 2 (2.7%) eyes were graded as clinically recurrence-occurred G2 and G3, respectively. The cumulative proportion of integrated recurrence-free G0/G1 at 24 months after surgery was 0.83 +/- 0.08. T3 of Tan's preoperative grading system was identified as the only risk factor for recurrence above G1 through multivariate logistic regression analysis (p = 0.02). CONCLUSIONS: The recurrence rate of the present TAMP study showed better results in comparison with 9.1 to 56.1% of recurrence rates in other studies. The TAMP has advantages of surgical procedure with ease, low complications, and low recurrence rates. Therefore, after surgical excision of primary pterygium, the authors concluded the TAMP is highly recommended for good clinical outcomes and low recurrence rates.

Comparison of Permanent Amniotic Membrane Transplantation and Temporary Amniotic Membrane Patch after Primary Pterygium Excision

PURPOSE: To compare the clinical results, recurrence rates, and recurrence-related risk factors of permanent amniotic membrane transplantation (PAMT, group 1) and temporary amniotic membrane patch (TAMP, group 2) after excision of primary pterygium. METHODS: Recurrence grades were evaluated for 66 eyes (T1, T2, and T3; 0, 32, and 34 eyes, respectively) in group 1 and 73 eyes (T1, T2, and T3; 2, 42, and 29 eyes, respectively) in group 2. Surgical results were classified into surgical success (G0 or G1), conjunctival recurrence (G2), and corneal recurrence (G3). Recurrence rates were analyzed based on gender, age, Tan's preoperative grading system, horizontal and vertical length of the preoperative pterygium, the corneal involvement size of the preoperative pterygium, and epithelial healing time. RESULTS: In the postoperative grading, 3 eyes (4.5%) and 1 eye (1.5%) in group 1, and 4 eyes (5.5%) and 2 eyes (2.7%) in group 2 were graded as clinically recurrence-occurred G2 and G3, respectively. There was no statistically significant difference in recurrence-occurred G2 and G3 cases between the two groups (p = 0.62). No risk factors of clinically significant G2 and G3 recurrence were identified in either group by Cox proportional hazards survival regression analysis. CONCLUSIONS: The results of the present study suggest that PAMT tends to lower the recurrence rate compared to TAMP because the PAMT group had more T3 eyes than the TAMP group, although the two groups showed no statistically significant difference in clinically significant recurrence after pterygium excision.

Effect of Inferior Conjunctival Transposition Flap Surgery for Primary Pterygium

PURPOSE: To evaluate the efficacy and safety of the inferior conjunctival transposition flap for primary pterygium surgery. METHODS: This study reviewed 59 eyes in 59 patients with primary pterygium who were treated with pterygium excision and an inferior conjunctival transposition flap. The inferior conjunctival flap was obtained from lower bulbar conjunctiva and was secured with 8-0 vicryl. Patients were followed-up on the third day after surgery and then at 1, 2, 4 and 12 weeks postoperatively. RESULTS: The mean patient age was 55.6 (ranging from 34 to 74) years. The mean follow-up period was 24.9 (ranging from 12 to 46) months. During the follow-up period, the pterygium recurred in one (1.7%) of the 59 eyes. There were no severe complications except for mild congestion and hemorrhage of the conjunctival flap. CONCLUSIONS: Inferior conjunctival transposition flap technique may be considered as a safe and effective method that reduces complications and recurrences after primary pterygium excision.

Limbal-conjunctival autograft transplantation for the management of primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the efficiency of limbal conjunctival autografting technique in patients with primary pterygium.·METHODS: Fifteen eyes of 15 patients with primary pterygium underwent surgery for the removal of pterygium with limbal conjunctival autograft. After the pterygium excision, the limbal portion of the graft was oriented and sutured to the limbus at the recipient bed with the epithelial surface upside. Recurrence was defined as fibrovascular tissue of more than 1 mm over the cornea in the area of previous pterygium excision.·RESULTS: With mean follow-up period of 8 months, neither recurrences nor serious complications were recorded among our patients.·CONCLUSION; Simple excision followed by limbal-conjunctival autograft transplantation is a safe and very effective way of treating primary pterygium.

Clinical Evaluation of Recurrence Rate of Pterygium Operation according to Mitomycin C Concentration

PURPOSE: The authors compared the recurrence rate and complications of primary pterygium operation with respect to mitomycin C concentration. METHODS: Four hundred twenty three eyes with primary pterygium underwent surgery using the bared sclera method. One hundred nineteen eyes randomly chosen were treated with 0.02% mitomycin C (Group I) twice a day for 5days, 138 eyes were treated with 0.01% mitomycin C (Group II), and 166 eyes were treated with 0.005% mitomycin C (Group III). RESULTS: During the mean follow-up period of 6 months, the overall recurrence rate was 14.7% (62 eyes). Recurrence rates in each group : 8.4% (10 eyes) in Group I , 13.7% (19 eyes) in Group II , and 19.9% (33eyes) in Group III . Complications seen in Group I were corneal abrasion (1 eye), symblepharon (1 eye), and postoperative corneal scar (1 eye). Complications seen in Group II were symblepharon (1 eye), and postoperative corneal opacity (2 eye) and seen in Group III were symblepharon (1 eye), and postoperative corneal opacity (1 eye). We conclude that a higher concentration of mitomycin C (0.2 mg/ml) reduces the recurrence rate of pterygium. CONCLUSIONS: We recommend the use of mitomycin C concentration of 0.02% twice a day for 5days to lower the recurrence rate and complications after excision of primary pterygium

Treatment of the primary pterygium by pterygium excision with intraoperative application of mitomycin C within 3 minutes

The authors evaluated the efficacy of intraoperative application of mitomycin C 0.4 mg/1 ml x 3 minutes in primary pterygium excision and compared this method with other’s. 166 patients (170 eyes) with primary pterygium were asigned randomly to 3 groups: group 1 received pterygium excision with intraoperative application of 0.4 mg/1 ml mitomycin C for 3 minutes (58 eyes: 14 eyes with pterygium. II degree, 44 with pterygium III-IV degree); group 2 received conjunctival autograf (56 eyes; 12 with pterygium II degree, 44 with pterrygium III-IV degree). Patients were followed 1,3,6 and >12 months after operation. Results: after a folow-up time there were not recurrences in patients of group 1 and 2; recurrences developed only in 15 (26.77%) of 56 eyes in group 3. There were not complications in and after operation. Conclusion: this study indicates that intraoperative application of mitomycin C in primary pterygium excision is an effective treatment for prevention of recurrence of pterygium.

A Clinical Study of the Recurrence in Primary Pterygia

We made the clinical evaluation of the 110 primary pterygia which were excised according to D'ombrain bare sclera method and modified Bangerter method at Chunchon Sacred Heart Hospital from May of 1985 to April of 1987. The followup period ranged from 3 months to 12 months(average: 6 months). The results were as follows: 1. The total recurrence rate was 7.3%. 2. The bilaterality in recurrent group was 62.5%, whereas was 34.3% in nonrecurrent group(p<0.05). 3. The number of vessels(from the base of pterygium toward apex) in recurrent group was 27-35(average: 30.6 +/- 2.6), whereas was 8-32(average: 20.5 +/- 6.1) in non-recurrent group(p<0.05). 4. The incidence of the previous recurrent history of the other eye in recurrent group was 37.5%, whereas was 3.9% in non-recurrent group(p<0.05). 5. The recurrence rate in modified Bangerter method group was 1.6%, whereas was 15.2% in D'ombrain bare sclera method group(p<0.05) and the modified Bangerter method group gave very good esthetic results.