Safety and efficacy of the technique of complete tenon's membrane excision and mitomycin C in pterygium surgery.
OBJECTIVE
Despite the established efficacy of mitomycin C (MMC) in preventing recurrence after pterygium surgery, there is no consensus on the optimal operative technique or dose of MMC.


METHODS
The authors retrospectively evaluated 90 single-headed pterygium resections performed with excision of the entire pterygium to the plica and removal of all Tenon's membrane from the scleral bed and rectus muscle. Bare sclera was exposed to 0.4 mg/mL MMC for 5 minutes for primary pterygia and 6 minutes for recurrent pterygia. These procedures were compared to a previous series of 58 procedures using bare sclera technique with MMC, but without extensive Tenon's membrane removal.


RESULTS
Extensive Tenon's membrane removal was associated with significantly fewer recurrences (6.7% vs. 21%; P< or =0.025) and significantly less pyogenic granuloma formation (24.4% vs. 40%; P< or =0.05). In addition, there were no vision-threatening complications, such as scleral melting or persistent corneal epithelial defects, in any of the patients.


CONCLUSIONS
These findings suggest that complete removal of all Tenon's membrane in the affected quadrant combined with topical MMC in the aforementioned dose is a safe method of pterygium excision with a low rate of recurrence and pyogenic granuloma formation.
Levy
Richard L
RL
Department of Ophthalmology, New York University School of Medicine, New York, NY, USA.
Naidu
Srilata
S
Jacobson
Lawrence
L
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003238:Connective Tissue / Q000187:drug effects / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008566:Membranes / Q000187:drug effects / Q000601:surgery; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D012590:Sclera / Q000187:drug effects; D055502:Secondary Prevention; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin