A comparative study of recurrent pterygium surgery - Limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap

Objective: To compare the recurrence rate following treatment of recurrent pterygia using one of two techniques-limbal conjunctival autograft transpla ntation versus low-dose intraoperative mitomycin C (0.2 mg/ml) combined wit h conjunctival flap closure. Design: Randomized clinical trial. Participants: Eighty-one patients with recurrent pterygia treated by limbal conjunctival autograft transplantation (n = 41) or mitomycin C combined wi th conjunctival flap (n = 40) participated. Intervention: Limbal conjunctival autograft transplantation or low-dose int raoperative mitomycin C application with conjunctival flap technique was pe rformed on recurrent pterygium cases. Main Outcome Measures: Recurrence of pterygium and postoperative complicati ons. Results: During mean follow-up periods of 16 +/- 1.9 and 15.5 +/- 1.5 month s, six recurrences (14.6%) in the limbal conjunctival autograft transplanta tion group and five recurrences (12.5%) in the mitomycin C group were obser ved (P = 0.77). The difference between the mean ages of recurrent (26.4 +/- 8.0 years) and nonrecurrent (35.8 +/- 11.9 years) cases for all patients w as statistically significant (P = 0.014). Technically, limbal conjunctival autograft transplantation seemed to be more difficult. The most frequent co mplication in limbal conjunctival autograft transplantation was graft edema , whereas that in the mitomycin C group was superficial keratitis. Conclusion: Both techniques showed similar recurrence rates in the treatmen t of recurrent pterygia. Although technically easier to perform, further fo llow-up is necessary to determine the long-term safety of low-dose intraope rative mitomycin C with conjunctival flap closure. The surgeon's familiarit y with either procedure should determine the method of choice.