SINGLE INTRAOPERATIVE APPLICATION VERSUS POSTOPERATIVE MITOMYCIN-C EYE DROPS IN PTERYGIUM SURGERY

Purpose: To determine the minimum effective dosage, most effective rou te of administration and long-term effects of mitomycin C for preventi on of recurrence after pterygium surgery. Methods: In a prospective, m asked study, 227 patients undergoing surgery for primary pterygia were assigned randomly to five groups: group 1 received a single intraoper ative application of 0.2 mg/ml mitomycin C for 3 minutes; group 2 rece ived a single intraoperative application of 0.4 mg/ml mitomycin C for 3 minutes; group 3 received mitomycin C eye drops 0.2 mg/ml three time s daily for 7 days; group 4 received mitomycin C eye drops 0.4 mglml t hree times daily for 14 days; group 5 acted as a control (surgery alon e), Results: After a mean follow-up time of 28 months, recurrence rate s of 6.66%, 4.08%, 4.26%, 4.44%, and 29.27%, respectively, were observ ed. Statistical analysis showed significant differences between groups receiving mitomycin C and the control (P less than or equal to 0.001) . There was no statistical difference among treated groups (P greater than or equal to 0.0681). No complications of therapy were observed. C onclusion: These results support the efficacy and relative safety of a single, low-concentration, intraoperative application of mitomycin C in pterygium surgery together with the use of a conjunctival flap, avo iding excessive cauterization of the sclera and leaving bare sclera.