title: Preoperative subconjunctival injection of mitomycin C versus intraoperative topical application as an adjunctive treatment for surgical removal of primary pterygium.
abstract: OBJECTIVE
  To compare the efficacy of preoperative local injection of mitomycin C (MMC) to intraoperative application of MMC in the prevention of pterygium recurrence after surgical removal.
  
  
  METHODS
  Seventy eyes of 70 patients with primary pterygia were randomly allocated to two groups. The first group (Group A, 35 eyes) received 0.1 ml of 0.15 mg/ml of subconjunctival MMC injected into the head of the pterygium 24 h before surgical excision with the bare sclera technique. The second group (Group B 35 eyes) underwent surgical removal with the bare sclera technique with intraoperative application of MMC (0.15 mg/ml) over bare sclera for 3 min. The study was performed between March 2007 and December 2008, and follow up was performed for 1 year postoperatively. Differences between frequencies in both groups were compared by the Chi-square test or Fisher exact test. Differences between means in both groups were compared by Student's t-test. P < 0.05 was considered significant.
  
  
  RESULTS
  The rate of pterygium recurrence was 5.70% in Group A and 8.57% in Group B at 1 year postoperatively (P>0.05). Postoperatively, scleral thinning occurred in one eye in each group that resolved by 5 months postoperatively. No serious postoperative complications occurred in either group.
  
  
  CONCLUSIONS
  Preoperative local injection of 0.15 mg/ml MMC is as effective as intraoperative topical application of 0.15 mg/ml MMC for preventing pterygium recurrence after surgical removal.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Ehab M
authors.initials: EM
authors.lastname: Ghoneim
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Abd-El Ghny
authors.forename: Amro A
authors.initials: AA
authors.lastname: Gab-Allah
authors.forename: Mohamed Z
authors.initials: MZ
authors.lastname: Kamal