Intraoperative adjuvant chemotherapy with mitomycin-C during pterygium surgery: a propspective phase II study

ABSTRACT

This study aimed to evaluate the efficacy of topical intermediate dose concentration [0.3 mg/ml] of mitomycin-C intraoperatively for a longer exposure time [5 minutes]on the recurrence rate, toxicity and the recurrence free survival. Between January 2000 and March 2003, pterygium excision has been performed for 19 eyes in 19patients with bare sclera technique, their median age was 42 years with male to female ratio of 2.21. Immediately after pterygium excision, topical mitomycin-C [0.3 mg/ml] was applied for 5 minutes over the bare scleral bed. One patient suffered a recurrence of pterygium in the area of previous excision during a median follow up of 20.5 months [range 3-39 months]. Pyogenic granuloma was reported in one patient and no other serious side effects were reported. The recurrence of pterygium occurred 18 months after excision and the 3-year recurrence free survival rate was 85%. The study concluded that single topical application of mitomycin-C 0.3 mg/ml for 5 minutes is safe and effective method to control recurrence of pterygium with minimal side effects than that reported with higher drug concentration. Further randomized studies to compare this technique with other methods is warranted to validate its efficacy