title: Combined conjunctival rotational autograft with 0.02% mitomycin C in primary pterygium surgery: a long-term follow-up study.
abstract: OBJECTIVE
  To compare the long-term outcomes of primary pterygium surgery with combined conjunctival rotational autograft and mitomycin C (CRA-MMC), mitomycin C alone (MMC) and limbal conjunctival autograft (LCAU).
  
  
  METHODS
  The outcomes of primary pterygium excision followed by conjunctival rotational autograft (CRA) combined with intraoperative 0.02% MMC for 5 min (group 1, CRA-MMC, n=61) were compared with historical control groups consisting of, pterygium excision with MMC (group 2, n=47), and, pterygium excision with limbal conjunctival autograft (LCAU) (group 3, n=29). The main outcome measures were recurrence rate and complications.
  
  
  RESULTS
  The mean follow-up period was 101±3 months, 138±2 and 137±2 months in the CRA-MMC, MMC and LCAU groups respectively. Recurrence was noted in one patient (1.6%) in the CRA-MMC, 12 patients with MMC (25.5%) and 2 patients with LCAU (6.9%). The difference in recurrence rate between CRA-MMC and MMC was statistically significant (p<0.001). Early postoperative complications included 3 conjunctival cysts (1 from the CRA-MMC, 2 with MMC alone), 2 symblephara (1 in the MMC group, 1 in the LCAU group), and 1 granuloma in the CRA-MMC group.
  
  
  CONCLUSIONS
  Pterygium excision followed by CRA-MMC or LCAU are effective means of preventing recurrence. The use of CRA-MMC in pterygium excision may be considered for cases where conventional autograft harvesting is contraindicated or when large grafts for double-head pterygium are required.
authors.affiliation: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Shatin, Hong Kong.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Tsim
authors.affiliation: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Shatin, Hong Kong.
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
authors.affiliation: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Shatin, Hong Kong.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.affiliation: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Shatin, Hong Kong.
authors.forename: Mary
authors.initials: M
authors.lastname: Ho
authors.affiliation: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, Shatin, Hong Kong.
authors.forename: Lulu L
authors.initials: LL
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage; D064592:Autografts; D003228:Conjunctiva / Q000166:cytology / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011625:Pterygium / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D014792:Visual Acuity
chemical_list: D000477:Alkylating Agents; D009883:Ophthalmic Solutions; D016685:Mitomycin
keywords: Cornea; Degeneration; Treatment Surgery