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Intraoperative mitomycin C versus autologous conjunctival autograft in surgery of primary pterygium with four‐year follow‐up
Author(s) -
Koranyi Gabor,
Artzén Ditte,
Seregard Stefan,
Kopp Eva Dafgard
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.01936.x
Subject(s) - medicine , pterygium , sclera , surgery , mitomycin c , astigmatism , complication , visual acuity , fibrous joint , vicryl , randomization , randomized controlled trial , physics , optics
. Purpose: To compare the 4‐year outcome of primary pterygium excision using intraoperative mitomycin C (MMC) with suturing a free conjunctival autograft (CA). Methods: A total of 115 eyes with nasal primary pterygium of 115 patients were included in the study. After randomization into two groups, the eyes were operated on by a single surgeon (GK). After excision of the pterygium, 56 eyes received 0.04% MMC intraoperatively on the bare sclera for 3 min and 59 eyes received a free CA sutured using 7‐0 Vicryl. Postoperative follow‐up was 4 years. Main outcome measures were recurrences, re‐operations, surgery time, complications, visual acuity and astigmatism. Statistical evaluation was performed with the chi‐squared test. Results: The recurrence rate was 38% in the MMC group and 15% in the CA group (p < 0.05). The re‐operation rate of the recurrences was 53% in the MMC group and 29% in the CA group. Average surgery time was 13 minutes (range: 6–22 min) in the MMC group and 26 min (range: 18–32 min) in the CA group (p < 0.01). There was no significant change in best‐corrected visual acuity and astigmatism. One major complication occurred in each group. The most frequently observed complication was delayed epithelial healing (40%) and mild scleral thinning (20%) in the MMC group and suture‐related inflammation in the CA group (10%). Conclusion: Pterygium surgery including free autologous conjunctival grafting is associated with fewer recurrences, re‐operations and complications than using the bare sclera technique together with single‐dose intraoperative MMC.