INTRAOPERATIVE MITOMYCIN-C TO PREVENT RECURRENCE OF PTERYGIUM AFTER EXCISION - A 30-MONTH FOLLOW-UP-STUDY

Objective: The purpose of the study was to examine the efficacy of int raoperative mitomycin C (MMC) in preventing recurrence of pterygium af ter excision and the postoperative complications encountered. Design: The study design was a prospective, randomized, clinical trial. Partic ipants: A total of 180 primary and recurrent pterygia were recruited f or the study. They were randomized into five groups: A, control with n o MMC; B, 0.02% MMC for 5 minutes; C, 0.04% MMC for 5 minutes; D, 0.02 % MMC for 3 minutes; and E, 0.04% MMC for 3 minutes. Intervention: All patients received pterygium excision with or without the above four m odes of intraoperative MMC application. Main Outcome Measures: Recurre nce of pterygium and postoperative complications such as superficial s cleral melting were measured. Results: At a mean follow-up of 30 (grou ps A-C) and 20 months (groups D and E), the respective recurrence rate s in groups A through E were 75%, 8.3%, 8.6%, 42.9%, and 22.9%. There were two cases of postoperative superficial scleral melting in group C , Otherwise, no major postoperative complications were encountered. Co nclusions: The midterm results of a single intraoperative application of MMC at the concentration of 0.02% for 5 minutes are encouraging. It s application as an adjunctive therapy for the surgical treatment of p terygium appeared to be safe and effective. However, because of the po ssibility of serious late complications, the authors suggest that this procedure be reserved for patients who have high probability of recur rence after excision of pterygium.