Comparison between conjunctival autograft and post-op mitomycin c in patients of pterygium

Authors

  • Telgote V Associate Professor, Department of Ophthalmolgy, Index Medical College & hospital and research Centre, Indore, MP, India.
  • Meena V Post graduate student, Department of Ophthalmolgy, Gandhi Medical college, Bhopal, MP, India.
  • Singh A PG Resident, Department of Ophthalmolgy, Index Medical College & hospital and research Centre, Indore, MP, India.

Keywords:

Pterygium, conjunctival autograft, intra-operative Mitomycin – C

Abstract

Introduction: Pterygium is one of the most common conjunctival diseases among ophthalmicpathologies, it is a fibro vascular encroachment of the conjunctival tissue on to the cornea, causing variable degree of ocular morbidity.The purpose of this study was to evaluate and compare recurrence rate in treating primary pterygium by two different techniques i.e. conjunctival autografting and intra-operative Mitomycin –C (0.02%) with reference to recurrence and complication rate. Material and Methods: Present study was the prospective, comparative case study involving 80 eyes of 40 patients came in Index Medical College in OPD and Camp conducted in different rural areas. Patient were assigned to two groups (A and B) randomly. Group A underwent limbalconjuctivalautograft. Group B underwent pterygium excision augmented with postoperative topical mitomycin C application. Result: Out of the 80 patients maximum numbers of patients were in the age group from 41 to 50 years. there was a male preponderance in this study with 47 males (58.75%) as compared to 33 females (41.25%). It was found that recurrence of pterygium occurred in 2 (5%) out of 40 eyes treated with limbalconjuctivalautograft and 3 (7.5%) out of 40 eyes in whom pterygium excision was followed by postoperative mitomycin C. In Group B, 2 patients showed the sclera thinning while no complication found in Group A. There were no statistically significant differencebetween two groups. Conclusions: Conjunctivallimbalautograft and postoperative MMC (0.02%) are both safe and effective adjuncts to primary pterygium surgery. The main prejudices against auto- grafting are the expertise and time required for the procedure. The recent use of biologic adhesives to fixate the autograft in place may simplify the procedure. Age of the patients was strongly associated with recurrence regardless of which procedure was used.

References

Taylor HR, West S, Muñoz B, Rosenthal FS, Bressler SB, Bressler NM. The long-term effects of visible light on the eye. Arch Ophthalmol. 1992 Jan; 110(1):99-104.

Wong AK, Rao SK, Leug AT et al. Inferior limbalconjunctivalauto-graft transplantation for recurrent pterygium. Indian J Ophthalmol.2000; 48: 21- 4.available on http://www.ncbi.nlm.nih.gov/

Reisman D, McFadden JW, Lu G. Loss of heterozygosity and p53 expression in Pterygium. Cancer Lett. 2004 Mar 31; 206(1):77-83.

Sebban A, Hirst LW. Pterygium recurrence rate at the Princess Alexandra Hospital. Aust N Z J Ophthalmol. 1991 Aug; 19(3):203-6.

Koranyi G, Seregard S, Kopp ED. Cut and paste: a no suture, small incision approach to pterygium surgery. Br J Ophthalmol. 2004 Jul; 88(7):911-4.

Nabawi KS, Ghonim MA, Ali MH. Evaluation of limbal conjunctival autograft and low-dose mitomycin C in the treatment of recurrent pterygium. Ophthalmic Surg Lasers Imaging. 2003 May-Jun; 34(3):193-6.

Raiskup F, Solomon A, Landau D, Ilsar M, FruchtPery J. Mitomycin C for pterygium: long term evaluation. Br J Ophthalmol. 2004 Nov; 88(11):1425-8.

Wong VA, Law FC. Use of mitomycin C with conjunctival autograft in pterygium surgery in AsianCanadians. Ophthalmology. 1999 Aug; 106(8):1512-5.

Young AL, Leung GY, Wong AK, Cheng LL, Lam DS. A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium. Br J Ophthalmol. 2004 Aug; 88(8):995-7.

Oguz H, Basar E, Gurler B. Intraoperative application versus postoperative mitomycin C eye drops in pterygium surgery. Acta Ophthalmol Scand. 1999 Apr; 77(2):147-50.

Manning CA, Kloess PM, Diaz MD, Yee RW. Intraoperative mitomycin in primary pterygium excision. A prospective, randomized trial. Ophthalmology. 1997 May; 104(5):844-8.

MeseretA ,Bejiga A, AyalewM.Prevalence of pterygium in rural community of Meskan District, Southern Ethiopia Ethiopian Journal of Health Development Vol. 22 (2) 2008 pp. 191- 194.www.ajol.info

McCarty CA, Fu CL, Taylor HR. Epidemiology of pterygium in Victoria, Australia. Br J Ophthalmol. 2000 Mar; 84(3):289-92.

Chui J, Coroneo MT, Tat LT, Crouch R, Wakefield D, Di Girolamo N. Ophthalmic pterygium: a stem cell disorder with premalignant features. Am J Pathol. 2011 Feb; 178(2):817-27. doi: 10.1016/j.ajpath.2010.10.037.

Lewallen S. A randomized trial of conjunctival autografting for pterygium in the tropics. Ophthalmology. 1989 Nov; 96(11):1612-4.

Shimazaki J, Shinozaki N, Tsubota K. Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol. 1998 Mar; 82(3):235-40.

MacKenzie FD, Hirst LW, Kynaston B, Bain C. Recurrence rate and complications after beta irradiation for pterygia. Ophthalmology. 1991 Dec; 98(12):1776- 80; discussion 1781.

Sharma A, Gupta A, Ram J, Gupta A. Low-dose intraoperative mitomycin-C versus conjunctival autograft in primary pterygium surgery: long term follow-up. Ophthalmic Surg Lasers. 2000 JulAug; 31(4):301-7.

Young AL, Leung GY, Wong AK, Cheng LL, Lam DS. A randomised trial comparing 0.02% mitomycin C and limbal conjunctival autograft after excision of primary pterygium. Br J Ophthalmol. 2004 Aug; 88(8):995-7.

Young AL, Ho M, Jhanji V, Cheng LL. Ten-year results of a randomized controlled trial comparing 0.02% mitomycin C and limbal conjunctival autograftin pterygium surgery. Ophthalmology. 2013 Dec; 120(12):2390-5. doi: 10.1016/j.ophtha.2013.05.033. Epub 2013 Jul 16.

Vichare N, Choudhary T2, Arora P3. A comparison between fibrin sealant and sutures for attaching conjunctival autograft after pterygium excision. Med J Armed Forces India. 2013 Apr; 69(2):151-5. doi: 10.1016/j.mjafi.2012.09.002. Epub 2012 Dec 29.

Chen P, Ariyasu R, Kaza V, et al. A Random- ized Trial Comparing Mitomycin C and ConjuctivalAutograft after Excision of Primary Pterygium, American Journal of Ophthalmology, Vol. 120, No. 2, 1995, pp. 151-160.

Lam DS, Wong AK, Fan DS, Chew S, Kwok PS, Tso MO. Intraoperative mitomycin C to prevent recurrence of pterygium after excision: a 30-month follow-up study. Ophthalmology. 1998 May; 105(5):901-4; discussion 904-5.

Figueiredo RS, Cohen EJ, Gomes JA, Rapuano CJ, Laibson PR. Conjunctival autograft for pterygium surgery: how well does it prevent recurrence? Ophthalmic Surg Lasers. 1997 Feb; 28(2):99-104.

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Published

2023-12-31

How to Cite

Telgote, V., Meena, V., & Singh, A. (2023). Comparison between conjunctival autograft and post-op mitomycin c in patients of pterygium. Biomedical Review: Journal of Basic and Applied Medical Sciences, 2(4), 118–123. Retrieved from https://biomedicalreview.in/index.php/jbams/article/view/23

Issue

Vol. 2 No. 4 (2015): Oct-Dec

Section

Original Research Article

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