Armaghane Danesh Bimonthly Journal (Oct 2009)
The Effect of Sub Conjunctive Injection of 2 Percent Mitomicin-C in Prevention of Recurrence of Pterygium
Abstract
Introduction & Objective: Pterygium is a wing-shaped fold of conjunctiva and fibrovascular tissue invades the superficial cornea. The occurrence of pterygia is strongly correlated with UV exposure, although dryness, inflammation, and exposure to wind and dust or other irritants are also important factors. Pterygium is usually asymptomatic, but it can cause photophobia, tearing, and foreign body sensation. It can also decrease vision by inducing with the regular and irregular astigmatism. Unfortunately, the recurrence rate is high averaging approximately 40% in various studies. Recurrences generally occur rapidly, within 2 to 3 months of surgery. The aim of the present study was to evaluate the effect of subconjunctivaly injection of mitomicin-C in preventing the recurrence of pterygium. Materials & Methods: This study was a simple randomized clinical trial which was carried out at Imam Sajjad Hospital of Yasuj, Iran. In this study, 157 eyes (48 men, 64 women) with primary pterygium were allocated in intervention (83 eyes, 54 patients) and control (74 eyes, 58 patients) groups. The mean age of the patients was 48. In the inversion group we injected .1 ML of mitomycin C .2% subconjunctivally in to the pterygium body, 1 month before pterygium excision. After the pterygium was excised, the bare sclera was covered by sliding adjacent superior conjunctiva in both groups. The follow up period was 3 months. Recurrence was defined as the postoperative re-growth of fibro-vascular tissue crossing the cornea. The data was analyzed by the SPSS software using Fisher's exact test and Chi-square test. Results: The recurrence rate was 1.2% (1 eye) and 9.45% (7 eyes) in intervention and control groups, respectively, with significance difference between groups (P= 0.027). The mean degree of astigmatism was improved with surgery in both groups. Conclusion: Both subconjunctival mitomycin C injection before pterygium excision and conjunctival auto graft are safe and are effective treatments in reducing of pterygium recurrence. Regarding the reduction of pterygium recurrence after subconjunctivaly Mitomicin-C injection, it can be concluded that this method is an effective treatment in pterygium surgery.
