Intraoperative application versus postoperative mitomycin C eye drops in pterygium surgery

Abstract

ABSTRACT.Purpose: Postoperative recurrence of pterygium occurs in many patients. Intraoperative and postoperative mitomycin therapy are two adjuvant treatment methods shown to lessen the high pterygium recurrence rate seen with simple excision alone. The authors designed a prospective, randomized study to explore the recurrence rate of pterygium after a single dosage of mitomycin C at the completion of pterygium excision, comparing it to postoperative mitomycin C therapy. Methods: Thirty-six patients with 40 primary and recurrent pterygia were randomized to 1 of 2 treatment groups: intraoperative mitomycin 0.2 mg/ml for 5 minutes (group 1) and postoperative mitomycin 0.2 mg/ml four times a day for 7 days (group 2). The mean follow-up time was 15 months (range, 6 to 24 months).

Pterygial Derived Fibroblasts Express Functionally Active Histamine and Epidermal Growth Factor Receptors

“…It is therefore reasonable to assume that medical intervention will remain curative with respect to this condition. Several therapeutic approaches have been proposed, but these often utilize generally acting molecules (Kria, Ohia and Amemiya, 1998b;Oguz, Basar and Gurler, 1999;Wong and Law, 1999) or employ radioactive sources (Paryani et al, 1994; Nishimura et al, 2000) to inhibit recurrence. In order to develop more selective approaches an improved understanding of the cellular systems expressed in the pathological tissue is required.…”

Mitomycin C and conjunctival autograft for recurrent pterygium

“…Intraoperative use of MMC was preferred in this study, due to the equal effectiveness of intraoperative and postoperative topical use [14] and serious complications seen with increasing cumulative dosage with postoperative topical use [15]. The selection of the 0.2 mg/ml concentration and the 3 min duration for this study were based on the results from our geographical zone [14,[16][17][18], the recurrent nature of these cases and concurrent CA transplantation.…”

Topical Cyclosporine A in the Prevention of Pterygium Recurrence

“…The reported recurrence rates range from 5 to 15% after the intraoperative use of mitomycin C [41]. But mitomycin C treatment carries the risk of serious complications, including poor epithelial healing [17], superficial punctate keratitis [17], late-onset scleral ulceration [42], microbial infection [43], secondary glaucoma [43], cataract [43], and corneal and scleral perforation [43]. …”

“…Mitomycin C acts as an alkylating agent and potent fibroblast inhibitor and causes irreversible damage to the DNA structures of the cell [17]. Postoperative administration of topical mitomycin 0.04–0.1% decreased the recurrence rate of pterygium in the range of 0–13% [40].…”

“…Recurrence is the most common complication after pterygium surgery [8,9,10,11,12,13,14]. Various adjuvant therapies or surgical modifications proposed for the prevention of a high incidence of pterygium recurrence after bare sclera excision include inter-alia beta irradiation [15], thiothepa drops [16], mitomycin C (MMC) application either intra- or postoperatively (by drops) [17], intraoperative application of 5-fluorouracil (5-FU) [8, 15], argon laser application [18], conjunctival autograft [19], conjunctival limbal autograft [19], amniotic membrane transplantation [19], and excimer laser [20]. …”