title: Conjunctival Short-term Evolution after Pterygium Excision.
abstract: OBJECTIVE
  To analyze conjunctival cytological features 1 month after pterygium excision using limbo-conjunctival autograft (LCA) with and without intraoperative mitomycin C and to assess tissue short-term evolution in both situations.
  
  
  METHODS
  Fifty-nine primary nasal pterygia from 59 patients were excised with LCA. Twenty-nine were treated with intraoperative mitomycin C 0.02% (MMC+) and 30 were treated without it (MMC-). Impression cytology was performed in nasal and temporal conjunctiva before and 1 month after the excision. Goblet cell density (GCD) and nucleus-to-cytoplasm nongoblet epithelial cell ratio were quantified.
  
  
  RESULTS
  Surgical strategy comparisons (intergroup comparisons): All the preoperative data were, in mean, within the reference range, except for a slight goblet cell hyperplasia in the area of the lesion in MMC+ but no significant differences were found between the groups (p = 0.079 for GCD and p = 0.245 for nucleus-to-cytoplasm ratio; analysis of variance). Clinically relevant differences after surgery were only shown in nasal GCD that was significantly lower in MMC+ than in MMC- (p = 0.000; analysis of variance), with the mean value in MMC+ slightly below normal values whereas that in MMC- remained normal. Tissue evolution (intragroup comparisons): No clinically relevant changes were found in MMC-. Data from MMC+ displayed no changes 1 month after surgery, except for nasal GCD that showed a significant reduction (p = 0.000; paired t test). Nevertheless, this GCD decrease was more modest than that previously described using mitomycin C without autograft, because in the present study, nasal GCD was not lower but similar to postoperative temporal data of the same eye (p = 0.164; paired t test).
  
  
  CONCLUSIONS
  Limbo-conjunctival autograft is a good technique for conjunctiva early recovery. When mitomycin C was added, the GCD reduction was lower than described using other surgical techniques. Mitomycin C, in optimal concentration and exposure, associated with LCA could be a good clinical option to minimize pterygium recurrence.
authors.affiliation: *PhD †MD Ocular Surface Research Group, Optics and Optometry Department, Universitat Politècnica de Catalunya-Barcelona Tech, Terrassa, Barcelona, Spain (all authors); and Department of Ophthalmology, Consorci Sanitari de Terrassa-Hospital de Terrassa, Terrassa, Barcelona, Spain (PP).
authors.forename: Gemma
authors.initials: G
authors.lastname: Julio
authors.forename: Sara
authors.initials: S
authors.lastname: Lluch
authors.forename: Pere
authors.initials: P
authors.lastname: Pujol
authors.forename: M
authors.initials: M
authors.lastname: Dolores Merindano
authors.forename: M
authors.initials: M
authors.lastname: Soledad Marqués-Calvo
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D002452:Cell Count; D003228:Conjunctiva / Q000166:cytology* / Q000637:transplantation; D004847:Epithelial Cells / Q000166:cytology; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D013508:Ophthalmologic Surgical Procedures; D011625:Pterygium / Q000188:drug therapy / Q000601:surgery*; D012590:Sclera / Q000187:drug effects; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin