Outcome of recurrent pterygium with intraoperative 0.02% mitomycin C and free flap limbal conjunctival autograft

ABSTRACT

To determine the re-recurrence and the postoperative complications in recurrent pterygium cases treated by intraoperative 0.02% Mitomycin C [MMC] and conjunctival autograft [CAG]. Quasi-experimental. Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad and Chandka Medical College Hospital, Larkana, from January to December 2010. Cases with recurrent pterygium were included in this study. Cases with history of first time pterygium and pterygium with conjunctival scaring, dry eye, glaucoma and vitreoretinal disease were excluded. After topical and subconjunctival anaesthesia, pterygium was excised in single piece. Intraoperative 0.02% MMC was applied on bare sclera for 2 minutes. CAG was excised from supero-temporal conjunctiva, and implanted on bare sclera. All cases were followedup for 6 months. Re-recurrence was defined as postoperative fibrovascular re-growth of 1.0 mm or more crossing the corneo-scleral limbus. Data was analysed as descriptive statistics. A total of 65 eyes of 65 cases were studied having mean age of 43.26 +/- 12.81 years. Among those, 41 [63.1%] were males and 48 [73.8%] belonged to rural area. The size of pterygium on cornea was 2-3 mm in 44 [67.7%] cases and 4-5 mm in 21 [32.3%] cases. Re-recurrence of pterygium was seen in 3 [4.6%] cases. Postoperative complications included conjunctival granuloma in 2 [3.1%] cases, graft necrosis in 2 [3.1%] cases, graft oedema in 3 [4.6%] cases and graft displacement in 3 [4.6%] cases. The intraoperative application of 0.02% MMC with CAG markedly reduces the risk of re-recurrence of pterygium and postoperative complications