RANDOMIZED TRIAL OF INTRAOPERATIVE MITOMYCIN-C IN SURGERY FOR PTERYGIUM

PURPOSE: To report the efficacy and safety of intraoperative applicati on of mitomycin C in surgery for pterygium. METHODS: Tn a prospective randomized and double blind study done within a span of 2.5 years in 5 0 eyes (50 patients) with primary progressive pterygium, mitomycin C i n a concentration of 0.02 mg/ml soaked in a sterile 5 x 5-mm sponge wa s applied over the bare sclera intraoperatively as an adjuvant therapy in 25 eyes after pterygium excision. These cases were compared with a nother 25 similar eyes that underwent the same procedure but in which gentamicin solution 0.3% was used instead of mitomycin C solution. RES ULTS: Three eyes (12%) in the mitomycin C group showed recurrence with in 7 months of surgery compared with eight eyes (32%) of the gentamici n control group within 3 to 5 months. Mild side effects, such as pain, photophobia, and delayed wound healing, were observed within the firs t 1 to 2 weeks postoperatively in both groups. In the mitomycin C-trea ted group, corneal changes in the form of superficial punctate keratit is (three eyes) and limbal avascularity (two eyes) subsided within 2 w eeks postoperatively. Follow-up time for these cases ranged from 18 to 21 months. CONCLUSIONS: A diluted solution of mitomycin C, 0.02 mg/ml , with an accurate size of sterile sponge applied to bare sclera after primary pterygium excision decreases the rate of recurrence to a grea ter extent than does gentamicin solution and is not associated with se vere complications.