Recurrence and Complication Rates among Current Pterygium Treatment Techniques: Pre-operative Subpterygeal Mitomycin-C Injection, Intraoperative Mitomycin C Application and Pterygium Excision with Conjunctival Autograft

Archimedes LD Agahan; Theresa Gladiola B Merca; Jose III V Tecson; Minnette A Panganiban

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Recurrence and Complication Rates among Current Pterygium Treatment Techniques: Pre-operative Subpterygeal Mitomycin-C Injection, Intraoperative Mitomycin C Application and Pterygium Excision with Conjunctival Autograft

Author: Archimedes L.D. Agahan ¹ ; Theresa Gladiola B. Merca ² ; Jose III V. Tecson ³ ; Minnette A. Panganiban ⁴
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1. iSight Vision Center, Quezon City Philippines ; Department of Ophthalmology and Visual Sciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila – Manila, Philippines
2. Department of Ophthalmology and Visual Sciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila – Manila, Philippines; The Medical City South Luzon Greenfield City, Don Jose Sta. Rosa, Laguna, Philippines
3. Department of Anatomy, College of Medicine, University of the Philippines Manila – Manila, Philippines
4. Manila Central University – Filemon D. Tanchoco Medical Foundation Hospital, Caloocan City, Philippines
Publication Type:Journal Article
Keywords: subpterygeal injection; conjunctival autograft; Mitomycin-C
MeSH: Pterygium Of Conjunctiva And Cornea; Pterygium; Mitomycin; Autografts; Conjunctiva; Conjunctivitis; Transplantation, Autologous
From: Acta Medica Philippina 2020;54(5):531-535
CountryPhilippines
Language:English
Abstract: Objective:This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft.
Methods:This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft.
Results:We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00).
Conclusion:There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.
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