RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
- VernacularTitle:УНТЭ-ИЙН НСТ-Д ХИЙГДЭЖ БУЙ ПТЕРИГИУМЫН САЛСТЫН НӨХӨН СУУЛГАЦ, ММС-ТЭЙ ПТЕРИГИУМЫН МЭС ЗАСЛЫН ҮР ДҮН
- Author:
Gantsooj N
1
;
Undarmaa T
1
;
Tuvshintugs B
1
;
Tumur G
1
;
Bolortungalag P
1
;
Sainbileg D
1
;
Enkhzul D
1
;
Tumurbaatar B
1
;
Burenjargal P
1
;
Enkh-Oyun Ts
2
Author Information
1. The First Central Hospital, Department of Ophthalmology
2. MNUMS, School of Public Health
- Publication Type:Journal Article
- Keywords:
Conjunctival Autograft;
Mitomycin C;
Pterygium
- From:Innovation
2018;12(3):28-30
- CountryMongolia
- Language:Mongolian
-
Abstract:
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.
