Efficacy of preoperative injection versus intraoperative application of mitomycin in recurrent pterygium surgery.

Purpose: To determine the efficacy of preoperative subconjunctival injection of mitomycin C a day before surgery in the management of recurrent pterygium. Materials and Methods: Randomized comparative case series. Fifty eyes with recurrent pterygium were randomly divided into two groups; the mitomycin injection group (25 eyes) and the mitomycin application group (25 eyes). The mitomycin injection group underwent preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before bare sclera pterygium excision surgery. The mitomycin application group underwent bare sclera pterygium excision with topical application of mitomycin C (same concentration). Results: At one year of follow-up, 24 of 25 eyes (96%) in the mitomycin injection group and 23 of 25 (92%) eyes in the mitomycin application group were free of recurrence. The difference was statistically insignificant. As regards postoperative complications, delayed epithelization (more than two weeks) occurred in two eyes (8%) in the mitomycin injection group and in one eye (4%) in the mitomycin application group. Scleral thinning was reported in one eye (4%) in the mitomycin application group which resolved within three weeks after surgery, no other serious postoperative complications were reported. Conclusion: Preoperative subconjunctival injection of mitomycin C in low dose (0.1 ml of 0.15 mg/ml) a day before pterygium surgery is a simple and effective modality for management of recurrent pterygium. It has the advantage of low recurrence and complications’ rate.

Surgical Outcome and Complications of Preoperative Subconjunctival Injection of Mitomycin C in Filtering Surgery

PURPOSE: We conducted a retrospective study to evaluate preoperative subconjunctival injection of mitomycin C (MMC) for surgical outcome and postoperative complications in trabeculectomy. METHODS: Twenty-eight eyes (22 patients) with glaucoma patients who were followed up for at least 6 months were injected subconjunctivally with 0.02 ml of 0.4mg/ml MMC (0.008 mg) mixed with 0.03 ml of 2% lidocaine before making the conjunctival incision and then trabeculectomy was performed after 5 minutes. RESULTS: Postoperative mean follow-up period was 21.1 months, preoperative mean IOP was 33.9 mmHg. Postoperative mean IOP at 1, 3, 6, 12month, and at the last follow-up were 9.0, 9.3, 9.5, 11.0, and 11.2 mmHg, respectively. There were statistically significant decreases of IOP in postoperation compared preoperation. When postoperative IOP were controlled below 21 mmHg and reduced under 30% compared with preoperative IOP, postoperative success rate at 1, 3, 6, 12 month, and at the last follow-up were 100%, 96%, 89%, 89%, and 86%, respectively. Postoperative complications were avascular cystic bleb in 8 eyes (29%), transient hypotony in 6 eyes (21%), shallow anterior chamber in 5 eyes (18%). Early aqueous leaking from conjunctival wound was in 4 eyes (14%). CONCLUSIONS: It is suggested that the preoperative subconjunctival injection of MMC of high concentration be used in filtering surgery. But the determination of volume and concentration is needed to prevent postoperative complications and long-term IOP lowering effect.

The Comparative Assessment of Filtering Bleb by Timing of subconjunctival Injection of Mitomycin-C in Glaucoma Filtering Surgery

In glaucoma filtering surgery, we conducted subconjunctival injection of Mitomycin-C(MMC) 12 hours before and after surgery, and examined histologic findings of the filtering bleb, and condition of the anterior chamber which ensued after the injection. We divided 15 full-grown rabbits into three groups, and for each group, administered subconjunctivally 0.1cc of 0.002%, 0.004%, and 0.008% MMC, respectively. The subconjunctival injection of MMC before surgery was given to the right eye and post-surgical injection to the left, and we examined the results 1, 2, 4, 7, and 14 days after the administration.In conclusion, subconjunctival injection of MMC 12 hours before glaucoma filtering surgery is shown to be more effective than the injection after the surgery.