Preoperative subpterygeal injection vs intraoperative mitomycin C for pterygium removal: comparison of results and complications.
OBJECTIVE
To evaluate and compare the recurrence rates and complications between 2 therapeutic methods for primary pterygium: subconjunctival injection of mitomycin C (MMC) 1 month before bare scleral excision and conjunctival rotational flap with intraoperative MMC use.


METHODS
Prospective, interventional, randomized clinical trial.


METHODS
setting: Institutional clinical trial in a tertiary, specialty eye hospital. study population and intervention: We included 82 eyes diagnosed with primary pterygium and randomly allocated them into 2 groups. Group A consisted of 36 eyes treated with subconjunctival injection of 0.02% MMC 1 month before bare scleral excision, and group B comprised 46 eyes that underwent conjunctival rotational flap with intraoperative 0.02% MMC for 2 minutes. Follow-up periods were at least 12 months (range, 12 to 18 months). main outcome measure: Recurrence and complication rate in each arm of study.


RESULTS
During the 1-year follow-up, 2 cases of clinical recurrence in third and sixth month of follow-up occurred in group B (recurrence rate, 4.3%). In group A, there was no clinically significant recurrence, but 2 cases of hypovascularity and whitening of sclera at the site of pterygium excision was observed. There was no other serious complication. There was no statistically significant difference between groups for recurrence rate, mean age, sex, or pterygium area.


CONCLUSIONS
Subconjunctival injection of MMC 0.02% (0.1 ml of 0.02% solution) 1 month before bare scleral excision is a quick, easy, and safe surgical procedure and is at least as effective as conjunctival rotational flap with intraoperative MMC for 2 minutes.
Khakshoor
Hamid
H
Khatam Anbia Eye Hospital, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Razavi
Mohammad Etezad
ME
Daneshvar
Ramin
R
Shakeri
Mohammad Taghi
MT
Ghate
Majid Farrokh
MF
Ghooshkhanehi
Haleh
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007430:Intraoperative Care; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012008:Recurrence; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
D000477:Alkylating Agents; D016685:Mitomycin