Intraoperative mitomycin C to prevent recurrence of pterygium after excision: A 30-month follow-up study12
Section snippets
Materials and methods
A prospective, randomized, double-masked study to assess the effectiveness and complications of a single intraoperative dose of MMC at the concentration of 0.02% and 0.04% for 5 minutes was started in September 1992. Although excellent results were obtained, there were two cases of superficial scleral melting in the 0.04% group. To titrate the minimal effective dosage, another 72 pterygia were randomized into 2 groups, 1 with 0.02% MMC for 3 minutes and the other with 0.04% MMC for 3 minutes.
Results
One hundred seventy-seven pterygia in 148 eyes of 108 patients (all ethnic Chinese) were included in this study. There were 63 males and 45 females ranging from 23 to 80 years of age (mean, 54.2 years). One hundred forty-three were primary pterygia and 34 were recurrent pterygia. One hundred fifty-two of the pterygia were located nasally, 1 temporally, and 12 both nasally and temporally.
Recurrence of pterygium was defined as corneal encroachment of 1.5 mm or more. Postoperative follow-up ranged
Discussion
The success of pterygium surgery has been limited by its high rate of recurrence. Adjunctive treatments can achieve better outcome. However, many of these adjuncts are not without risks. Our results indicated that intraoperative MMC has a narrow therapeutic range. Application of 0.02% and 0.04% intraoperative MMC for 3 minutes was ineffective (groups D and E, Table 1). Whereas intraoperative MMC of 0.04% for 5 minutes was effective (group C, Table 1), it caused superficial scleral melting. Many
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The authors have no proprietary interest in any of the materials used in this study.
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The protocol was approved by the ethics committee of the Chinese University of Hong Kong.