A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium

Young, Alvin L.; Leung, Gilberto Ka Kit; Wong, A K K; Cheng, Lulu; Lam, Dennis S C

doi:10.1136/bjo.2003.036830

Cited by 99 publications

(73 citation statements)

References 17 publications

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“…Disadvantages are rare, but devasting complications including scleral ulceration and necrosis, secondary glaucoma, corneal perforation, cataract formation, iritis, and irreversible damage to stem cells may occur. 1,12 In this study, in addition to intraoperative MMC, AMT was used to evaluate whether the use of amniotic membrane in addition to intraoperative MMC may further reduce recurrence rate of pterygium. Addition of AMT to MMC may also make ocular surface reconstruction possible even after extensive fibrovascular tissue removal.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence rates are reported to be 5.4-21% when MMC is used alone in treating primary pterygium. [1][2][3][4][5][6][7][8][9][10]11 Recurrence rate of recurrent pterygium is still as high as 12.5-19.2% in using MMC alone, 12,13 and 12.5-33.3% when using AMT alone. 13,14 It is therefore expected that there is no single and simple method achieving satisfactory results for complicated cases, especially in eyes with severe symblepharon and motility restriction.…”

Section: Introductionmentioning

confidence: 99%

“…Recurrence after primary excision varies from 24 to 89%. 1 Recurrent pterygium is more difficult to treat than primary pterygium because it is often accompanied by increased conjunctival inflammation and accelerated corneal involvement. 2 Surgical procedures for treatment of pterygium (including recurrent pterygium) include excision with mitomycin C (MMC), conjunctival autograft, limbal autograft, amniotic membrane transplantation, and lamellar keratoplasty.…”

Section: Introductionmentioning

confidence: 99%

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Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium

Fallah

Golabdar

Amozadeh

et al. 2006

Eye

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Aim: To compare the efficacy and complications of conjunctival limbal autograft (CLAU) and amniotic membrane transplantation (AMT) vs intraoperative mitomycin C (MMC) and AMT for treatment of recurrent pterygium. Methods: Forty eyes of 40 patients with recurrent pterygium underwent CLAU and AMT (20 eyes) or intraoperative MMC (0.02%, 3 min) and AMT (20 eyes). Three eyes (15%) had symblepharon before surgery in each group. Recurrence was compared in each group by using v 2 test. Results: No major postoperative complications occurred during 6-19 months of follow-up. In CLAU/AMT group, no pterygium recurrence was observed. Recurrence occurred in four eyes (20%) in MMC/AMT group after 3 and 4 months (P-value ¼ 0.035, v 2 test). No recurrence of pterygium or symblepharon was seen in six eyes with recurrent pterygium and symblepharon (three eyes in each group). Conclusion: CLAU with AMT seems to be more effective than intraoperative MMC with AMT for treatment of recurrent pterygium.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium

Fallah

Golabdar

Amozadeh

et al. 2006

Eye

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“…2 MMC is an alkylating agent that acts by inhibiting fibrovascular growth in the subconjunctival space. 4,5 Conjunctival graft variations would include conjunctival-limbal autograft, amniotic membrane graft, and conjunctival rotational autograft. 3 Pterygium surgery is most commonly performed under a local anaesthetic, such as retrobulbar or peribulbar injections.…”

Section: Introductionmentioning

confidence: 99%

Randomised controlled trial on the effectiveness of lidocaine gel vs tetracaine drops as the sole topical anaesthetic agent for primary pterygium surgery

Young

Leung

Cheng

et al. 2008

Eye

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Purpose To determine the effectiveness of lidocaine 2% gel vs tetracaine 1% drops in primary pterygium surgery. Methods This was a prospective, randomised controlled trial. Forty consecutive patients who had primary pterygium underwent surgical excision of primary pterygium and mitomycin C. Patients were randomised into two groups. Group 1 received tetracaine 1% drops and solcoseryl eye gel (Solco Basel AG, Switzerland). Group 2 received xylocaine 2% gel (lidocaine hydrochloride 2% gel, AstraZeneca, Sweden) topically and normal saline drops 0.9%. Additional tetracaine drops were given to patients who experienced pain preoperatively. The primary outcome was the pain experienced during and after surgery. Immediately after the operation, pain and discomfort scores were assessed by the patients and doctor using a 10-point linear analogue scale. The stages of the operation were divided into the following: stage 1Ffirst incision, stage 2Fpterygium body excision, stage 3Fconjunctival suturing, and stage 4Fimmediate postoperative after patching. Results There was no statistically significant difference in the mean pain scores experienced during pterygium excision (3.03 ± 2.35 for the lidocaine group and 3.98 ± 2.18 for the tetracaine group). However, for stage 3, there was a statistically significant difference in mean pain scores experienced during closure (P ¼ 0.03) (0.47±0.84 for the lidocaine gel group and 1.43±1.66 for the tetracaine group), with patients of group 2 experienced less pain. The mean number of additional drops required by the eyes in lidocaine gel group was also significantly (0.16±0.11) less than the tetracaine group (0.67 ± 0.09, P ¼ 0.001). Conclusions Topical administration of lidocaine 2% gel or tetracaine 1 % drops are both effective anaesthetic agents for primary pterygium surgery and mitomycin C. However, lidocaine gel is superior to tetracaine eye drops and its application is more convenient with a less frequent application and a sustained duration of action.

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“…may have a profound influence on the recurrence rate 15 . More over conjunctival grafts including limbal epithelium generally yield better results because it will help to restore its barrier function 24 . In 1998, Lewallen S 25 published report of a randomized trial of the conjunctival autografting technique for pterygium removal.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Primary Pterygium With Conjunctival Autograft and Mitomycin C. A Comparative Study

Narsani¹,

Jatoi²,

Gul³

et al. 2008

j liaquat uni med health sci

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One hundred cases of primary pterygium were treated with conjunctival autograft and Mitomycin C 0.02% intra-operatively for 5 minutes at the bare sclera by cotton swab. Anesthesia used was topical proparacaine and local infiltration of lignocaine. Patients were followed postoperatively for 9-12 months to find the recurrence (defined as fibrovascular tissues invading the cornea 1mm or more) of pterygium and complications. All surgeries were performed by one surgeon. RESULTS: Of the hundred cases 17 were lost in follow-up. In remaining eighty-three eyes received conjunctival autograft (CAG n=52) and Mitomycin C (MMC n=31). There were 4 (7.69%) recurrences in group A (CAG) and 8 (16.13%) recurrences in group B (MMC). There was statistically significant difference in the recurrence rate between the two groups. The post operative complications in MMC group were two punctate epithelial keratitis, one conjunctival granuloma and one has dellen. No significant complications were encountered in conjunctival autograft group. CONCLUSION: Simple excision of pterygium followed by conjunctival autograft has the lowest recurrence rate and minimal incidence of complications as compared to intraoperative Mitomycin C.

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A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium

Cited by 99 publications

References 17 publications

Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium

Transplantation of conjunctival limbal autograft and amniotic membrane vs mitomycin C and amniotic membrane in treatment of recurrent pterygium

Randomised controlled trial on the effectiveness of lidocaine gel vs tetracaine drops as the sole topical anaesthetic agent for primary pterygium surgery

Treatment of Primary Pterygium With Conjunctival Autograft and Mitomycin C. A Comparative Study

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