Impression cytology to study conjunctival epithelial morphology after pterygium excision with mitomycin-c and conjunctival autograft, limbal autograft (A Pilot study)

Purpose: To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft. Methods: 180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively. Results: group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation. Conclusion: Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

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Recurrence rate with use of intraoperative Mitomycin C versus Conjunctival Autograft following pterygium excision

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.306.5191 ◽

1969 ◽

Vol 30 (6) ◽

Cited By ~ 1

Author(s):

Quratulain Paracha

Keyword(s):

Mitomycin C ◽

Recurrence Rate ◽

Conjunctival Autograft ◽

Pterygium Excision

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Recurrence and Complication Rates among Current Pterygium Treatment Techniques: Pre-operative Subpterygeal Mitomycin-C Injection, Intraoperative Mitomycin C Application and Pterygium Excision with Conjunctival Autograft

Acta Medica Philippina ◽

10.47895/amp.v54i5.2242 ◽

2020 ◽

Vol 54 (5) ◽

Author(s):

Archimedes L.D. Agahan ◽

Theresa Gladiola B. Merca ◽

Jose V. Tecson III ◽

Minnette A. Panganiban

Keyword(s):

Mitomycin C ◽

Tertiary Hospital ◽

Controlled Clinical Trial ◽

Complication Rates ◽

Recurrence Rates ◽

Conjunctival Autograft ◽

Treatment Techniques ◽

Significant Difference ◽

Pterygium Excision

Objective. This study aims to determine recurrence and complication rates among patients who underwent threecurrent pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperativeapplication of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. Methods. This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosedprimary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior topterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excisionwith conjunctival autograft. Results. We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group.After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40[15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C,while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication ratesamong the three procedures (P=1.00). Conclusion. There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.

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Twelve-Year Outcomes of Pterygium Excision with Conjunctival Autograft versus Intraoperative Mitomycin C in Double-Head Pterygium Surgery

Journal of Ophthalmology ◽

10.1155/2015/891582 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Tommy C. Y. Chan ◽

Raymond L. M. Wong ◽

Emmy Y. M. Li ◽

Hunter K. L. Yuen ◽

Emily F. Y. Yeung ◽

...

Keyword(s):

Mitomycin C ◽

Recurrence Rate ◽

Clinical Assessment ◽

Original Study ◽

Conjunctival Autograft ◽

Significant Difference ◽

Pterygium Surgery ◽

Pterygium Excision ◽

Double Head

Purpose. The study aims to compare the long-term outcome of conjunctival autograft (CAU) and mitomycin C (MMC) in double-head pterygium surgery.Methods. This is a follow-up study of a comparative interventional trial. Thirty-nine eyes of the 36 patients with double-head pterygium excision in the original study 12 years ago were recruited for clinical assessment. Seven out of the 36 patients were lost. In the original study, each eye with double-head pterygium was randomized to have pterygium excision with CAU on one “head” (temporal or nasal) and MMC on the other “head.” All patients were invited for clinical assessment for conjunctival bed status and the presence of pterygium recurrence in the current study.Results. There was no significant difference between the size, morphology, and type of pterygium among the two treatment groups. The recurrence rate of CAU group and MMC group 12 years after excision was 6.3% and 28.1%, respectively (P=0.020). Among eyes without recurrence, the conjunctival bed was graded higher in the MMC group than the CAU group (P=0.024).Conclusion. The use of conjunctival autograft has a significantly lower long-term recurrence rate than mitomycin C in double-head pterygium surgery.

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Complications and Recurrence after Pterygium Excision using Mitomycin C Eye Drops versus Sutureless and Glue Free Conjunctival Autograft: A Prospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44271.13926 ◽

2020 ◽

Author(s):

Prachi Shukla ◽

Suman Bhartiya

Keyword(s):

Mitomycin C ◽

Recurrence Rate ◽

Eye Drops ◽

Conjunctival Autograft ◽

Group A ◽

Pterygium Excision ◽

The Difference ◽

One Year ◽

Group B

Introduction: Recurrence is the most common problem with pterygium excision. Various adjunctive methods have been described to decrease the recurrence rate of pterygium. Mitomycin C (MMC) and limbal Conjunctival Autograft (CAG) are most commonly used methods to reduce its recurrence. Aim: To compare the recurrence rate of pterygium and the complications with MMC eyedrops after bare sclera pterygium excision versus sutureless and glue free CAG. Materials and Methods: Total 104 eyes were divided into two groups (A and B) of 52 eyes each. Group A patients underwent bare sclera excision of pterygium followed by 0.01% MMC eye drops BD (twice a day) for five days and Group B patients had sutureless and glue free CAG using oozing blood as tissue adhesive after pterygium excision. The patients were followed-up postoperatively on day 1, day 3, day 7, one month, three months, six months and one year. All the patients were examined for recurrence and complications. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 16 and student’s t-test was applied for comparison. Results: A total of 104 eyes of 92 patients were divided into two groups (A and B) of 52 each. The mean age of Group A was around 45 year and group B was around 43 years and the difference was statistically insignificant (p>0.05). Total three patients had recurrence in one year of follow-up in group A, out of which first case appeared before the end of 1st month, second before the completion of 3rd month and the third case at the last follow-up. In group B only one case presented with recurrence at 6th month follow-up. The difference between the recurrences in both the groups was statistically insignificant (p>0.05). Short term complications were observed in five patients in group A. One patient had corneal thinning; one had scleral thinning, two patients presented with avascular sclera and one patient with granuloma. In group B, 18 patients with graft retraction, eight with graft oedema, five with sub-conjunctival graft haemorrhage and one with granuloma were observed. All these complications resolved by the time. Long term complications were not observed in any patient of both the groups. Conclusion: This study concluded that the use of MMC eye drops (0.01%) BD or glue free and sutureless CAG after pterygium excision is safe and effective treatment modalities for pterygium.

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