J Korean Ophthalmol Soc.  2009 Jul;50(7):996-1004. 10.3341/jkos.2009.50.7.996.

Clinical Research on Effectiveness of Mitomycin C on Primary Pterygium With Limbal-Conjunctival Autograft

• Lee BH
• Lee JW
• Park YJ
• Lee KW

• KMID: 2212486
• DOI: http://doi.org/10.3341/jkos.2009.50.7.996

Abstract

PURPOSE
To evaluate the effectiveness of Mitomycin C used as a combined therapy along with limbal-conjunctival autograft for primary pterygium. METHODS: Thirty eyes of 29 patients received Mitomycin C (0.02% MMC 3 minutes) with limbal-conjunctival autograft, and 30 eyes of 28 patients received limbal-conjunctival autograft alone. Recurrence and complications were evaluated in the patients at 2 weeks, 1, 3, 6 and 12 months postoperatively. RESULTS: Mean follow-up periods were 13.4+/-2.1 and 13.9+/-2.9 months, respectively. Between the two groups, recurrence in the conjunctiva or the cornea was not observed during the follow-up period. In the Mitomycin C use group, complications included a granuloma at the donor site (1 eye, 3.3%), wound dehiscence (2 eyes, 6.7%), and subgraft hemorrhage (2 eyes, 6.7%). In comparison, in the group treated with limbal-conjunctival autograft alone, complications included granuloma at the donor site (1 eye, 3.3%), pseudopterygium at the donor site (1 eye, 3.3%), wound dehiscence (3 eyes, 10%), and subgraft hemorrhage (2 eyes, 6.7%). CONCLUSIONS: The use of Mitomycin C as an adjuvant therapy has no significant effect on the recurrence rate in primary pterygium with limbal-conjunctival autograft.

Keyword

Limbal-conjunctival autograft; Mitomycin C; Pterygium

MeSH Terms

Conjunctiva
Cornea
Eye
Follow-Up Studies
Granuloma
Hemorrhage
Humans
Mitomycin
Pterygium
Recurrence
Tissue Donors
Mitomycin

Figure

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  Figure 1. Dashed line is extensive excision profiles of a pterygium. The extensive excision was designed to resect the maximum surface of pterygium, while preserving the conjunctiva.

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  Figure 2. The photograph of the anterior segment on day 1 after pterygium excision and superior limbal conjunctival autograft transplantation with temporary amniotic membrane patch. Under the temporary amniotic membrane transplantation, notice the relatively low inflammatory appearance of the eye, well-positioned graft and reestablishment of the normal limbal architecture.

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  Figure 3. Left column (A, B: Limbal-conjunctival autograft without 0.02% MMC, C, D: Limbal-conjunctival autograft with 0.02% MMC) Images of preoperative fleshy grade 3 nasal primary pterygium. Right column (E, F: Limbal-conjunctival autograft without 0.02% MMC, G, H: Limbal-conjunctival autograft with 0.02% MMC) Images of the LCAT of the same patients 6 months after the surgery. Well-positioned graft and reestablishment of the normal limbal architecture are observed with no signs of recurrences in all subjects. Notice: The lack of scar on the donor and recipient conjunctiva due to the use of bioadhesives, and the cosmetic advantage due to appropriate size of conjuctival flap after extensive pterygium excision are apparent.

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  Figure 4. Postoperative complications. (A) Granuloma at donor site. (B) Wound dehiscence (arrowhead). (C) Excessive fibrovascular tissue proliferation at donor site (similar to pseudopterygium). (D) Subgraft hemorrhage.

Reference

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