Comparison of single-drop mitomycin C regime with other mitomycin C regimes in pterygium surgery.
OBJECTIVE
To evaluate the safety and efficacy of single-drop instillation of mitomycin C (MMC) in pterygium surgery and to compare the results with both postoperative and intraoperative application of MMC.


METHODS
Eighty eyes of 72 patients with pterygium were randomised into 4 equal groups: group 1--control--bare scleral excision (BSE); group 2--BSE with single-drop instillation of mitomycin C (MMC) 0.02% at the end of the surgery; group 3--BSE with postoperative MMC 0.02% drops twice a day for 5 days; and group 4--BSE with intraoperative MMC 0.02%.


RESULTS
The recurrence of pterygium was observed in 14 (70%), 4 (20%), 4 (20%) and 3 (15%) eyes of group 1, 2, 3, and 4 respectively. The recurrence rate after BSE with single drop MMC regime (group 2) was significantly lower than group 1 recurrence (P=0.001) and was statistically comparable to that of group 3 and 4. Scleral defects in the bare area occurred in 4 (20%), 16 (80%) and 16 (80%) eyes of group 2, 3, and 4 respectively. The incidence of scleral defects was significantly lower in group 2 compared to group 3 (P=0.0001) and group 4 (P=0.0001). Compared to group 1 and 2, a significant delay in wound epithelialisation occurred in group 3 (P=0.003) and 4 (P=0.004). An ischaemic area in the bare sclera developed in 8 (40%) and 6 (30%) eyes of group 3 and 4 respectively, while ischaemic area did not develop in group 1 and 2.


CONCLUSIONS
Single-drop instillation of 0.02% mitomycin C following pterygium excision appears both safe and efficacious.
Gupta
Ved P
VP
Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Saxena
Tishu
T
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012008:Recurrence; D012449:Safety; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin