Intraoperative daunorubicin versus conjunctival autograft in primary pterygium surgery.
OBJECTIVE
To evaluate the safety and efficacy of intraoperative daunorubicin during a bare sclera procedure in primary pterygium surgery and to compare with conjunctival autograft.


METHODS
The data for 84 patients who underwent pterygium surgery at Safdarjung Hospital and Guru Nanak Eye Center were analyzed retrospectively. The patients were divided into two groups: group A, those who underwent bare sclera excision along with conjunctival autograft, and group B, those who underwent bare sclera excision with intraoperative daunorubicin (0.02%) for 3 minutes. We evaluated pterygium recurrence and postoperative complications for both groups. Recurrence of pterygium was defined as growth of 2 mm of fibrovascular tissue over the corneoscleral limbus into the clear cornea in the area of previous pterygium excision.


RESULTS
Follow-up ranged from 18 to 37 months (mean, 27). Recurrence rates of 8.33% (three of 36) and 7.14% (three of 42) were found in groups A and B, respectively. When compared statistically, the difference was not significant. All the recurrences occurred in patients younger than 30 years of age. Pyogenic granuloma, graft edema, loose graft, and dellen formation were seen, respectively, in 5.5% (two of 36), 2.77% (one of 36), 2.77% (one of 36), and 2.77% (one of 36) patients in group A. Nine of 42 (21.42%) patients in group B had chemosis of the conjunctiva and two of 42 (4.76%) had delayed epithelization.


CONCLUSIONS
We conclude that intraoperative daunorubicin (0.02%) and conjunctival autograft are both equally effective adjuncts to pterygium surgery.
Dadeya
Subhash
S
Department of Ophthalmology, Safdarjung Hospital, New Delhi, India. dadeya86@hotmail.com
Kamlesh
Khurana
Charu
C
Fatima
Shibal
S
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D003228:Conjunctiva / Q000637:transplantation*; D003630:Daunorubicin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011625:Pterygium / Q000601:surgery*; D012449:Safety; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D003630:Daunorubicin