Long-term follow-up study of mitomycin eye drops as adjunctive treatment of pterygia and its comparison with conjunctival autograft transplantation.
We observed 48 patients for 7-21 months (mean, 18 months) after pterygium excision and 2 weeks of placebo or mitomycin topical therapy to evaluate whether or not the short-term efficacy of mitomycin in preventing pterygium recurrence would be reflected in long-lasting efficacy as well. Placebo-treated pterygia showed a 73% recurrence rate. One of 58 (1.7%) mitomycin-treated pterygia recurred (p less than 0.05). We also performed a pilot study comparing pterygia treated with excision followed by 0.4 mg/ml of mitomycin to pterygia treated with excision coupled with conjunctival autograft transplantation to estimate the number of patients required for a randomized clinical trial comparing these two treatment modalities and thereby to decide whether or not such a study would be justified. Thirteen primary and two recurrent pterygia were treated with mitomycin, while 14 primary and one recurrent pterygia were treated with conjunctival autograft transplantation. With mean follow-up times of 4 and 6 months, respectively, no recurrences were noted in the mitomycin-treated group, while the conjunctival autograft transplantation group had one recurrence (6.6%). We estimate that 400 patients would be required for a properly designed clinical trial comparing these two effective therapies for prevention of recurrent pterygia. We conclude that such a study is unjustified, and further conclude that the vastly less expensive, simple therapy of mitomycin eye drops is the more appropriate treatment.
Singh
G
G
King/Drew Medical Center, Charles R. Drew University of Medicine and Science, Los Angeles, California.
Wilson
M R
MR
Foster
C S
CS
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011625:Pterygium / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D014182:Transplantation, Autologous
D008937:Mitomycins