title: Effects of mitomycin C on corneal endothelial cell counts in pterygium surgery: role of application location.
abstract: OBJECTIVE
  To evaluate changes in corneal endothelial cell counts after pterygium surgery with application of mitomycin C (MMC) either on the perilimbal sclera or in the subconjunctival space.
  
  
  METHODS
  Prospective, randomized interventional study.
  
  
  METHODS
  Fifty-six eyes of 56 patients with primary pterygium underwent excision followed by removal of subconjunctival fibrovascular tissue, 0.02% MMC application, and amniotic membrane transplantation. These were stratified randomly into 2 groups. In 1 group (n = 28), MMC was applied on the perilimbal bare sclera (sclera group), and in other group (n = 28), MMC was applied under conjunctiva, where subconjunctival fibrovascular tissue was removed (subconjunctiva group). Based on severity of pterygium fleshiness, MMC was used for 1, 3, or 5 minutes in 8, 13, and 7 eyes, respectively, in the sclera group and in 9, 13, and 6 eyes, respectively, in the subconjunctiva group. Central corneal endothelial cell counts were evaluated before and during 6 months of follow-up after surgery.
  
  
  RESULTS
  Mean preoperative endothelial cell count was 2810 ± 278 cells/mm(2) in the sclera group and 2857 ± 332 cells/mm(2) in the subconjunctiva group. Mean endothelial cell losses in sclera and subconjunctiva groups were 9.7% and 9.0% at 1 week, 6.5% and 6.5% at 1 month, 4.0% and 5.0% at 3 months, and 3.4% and 4.8% at 6 months, respectively, with no statistically significant difference between the 2 groups. Longer durations of MMC application were associated with significantly greater endothelial losses in both groups.
  
  
  CONCLUSIONS
  Regardless of application location, MMC use during pterygium surgery can cause a significant decrease in central endothelial cell count.
authors.affiliation: Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran. Akheirkh@yahoo.com
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kheirkhah
authors.forename: Ali
authors.initials: A
authors.lastname: Izadi
authors.forename: Mohammad Yaser
authors.initials: MY
authors.lastname: Kiarudi
authors.forename: Rahman
authors.initials: R
authors.lastname: Nazari
authors.forename: Hesam
authors.initials: H
authors.lastname: Hashemian
authors.forename: Mahmoud Jabbarvand
authors.initials: MJ
authors.lastname: Behrouz
mesh_terms: D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D000650:Amnion / Q000637:transplantation; D002452:Cell Count; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects; D055954:Corneal Endothelial Cell Loss / Q000139:chemically induced* / Q000175:diagnosis; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012590:Sclera / Q000187:drug effects; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin