Long-term results after bare sclera pterygium resection with excimer smoothing and local application of mitomycin C.
OBJECTIVE
To evaluate the long-term results and complications after bare sclera pterygium excision with local application of mitomycin C and consecutive smoothing of the wound area with an excimer laser (PTK).


METHODS
This was an observational case series of 133 eyes of 101 patients who underwent pterygium surgery using the bare sclera technique. Thirty-one of these treated eyes (23%) were recurrences with a mean of 3 previous operations. After pterygium surgery, phototherapeutic keratectomy with an ArF:excimer laser was performed in the area of the excision. Additionally, all patients were treated with mitomycin C 0.02% twice daily for 4 days. Median follow-up was 53 months (minimum, 36).


RESULTS
In the group with primary pterygia, 3 recurrences occurred after 6, 12, and 28 months (recurrence rate, 2.9%). In the group with previous pterygium operations, 2 recurrences (recurrence rate, 6.4%) were recorded. Uncorrected visual acuity of all treated patients improved from 0.61 preoperatively to 0.79 postoperatively (P < 0.0001), best corrected visual acuity increased from 0.82 to 0.91 (P = 0.0001) [LogMAR]. Mean astigmatism was significantly reduced from 1.54 D preoperatively to 0.61 D postoperatively (P < 0.0001). In 7 eyes, discrete granulomas developed postoperatively (5.3%); in 3 cases (2.3%), dellen formation occurred that persisted for a maximum of 4 months. No further complications were recorded during the follow-up.


CONCLUSIONS
Pterygium excision using the bare sclera technique, phototherapeutic keratectomy, and local application of mitomycin C 0.02% eyedrops is a safe method with good functional results and a low recurrence rate.
Walkow
Tony
T
Department of Ophthalmology, Centro Klinik, Oberhausen, Germany.
Daniel
Jan
J
Meyer
Carsten H
CH
Rodrigues
Eduardo B
EB
Mennel
Stefan
S
D003316:Corneal Diseases / Q000209:etiology; D005128:Eye Diseases / Q000209:etiology; D005500:Follow-Up Studies; D006099:Granuloma / Q000209:etiology; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D054018:Lasers, Excimer; D016685:Mitomycin / Q000009:adverse effects / Q000627:therapeutic use*; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D011625:Pterygium / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012590:Sclera / Q000473:pathology*; D016896:Treatment Outcome; D014792:Visual Acuity
D016685:Mitomycin