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A. F. Scheuerle, H. E. Voelcker, S. Beutelspacher; Safety and Efficacy of Postoperative Mitomycin C (MMC) Eye Drops in Pterygium Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6030.
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Pterygium consists of pathologic conjunctival tissue that proliferates on the clear cornea. Besides sophisticated surgical techniques the use of intraoperative antimetabolic eye drops like mitomycin C (MMC) is a common method to prevent recurrence. In this study we investigated the efficacy and safety of postoperative MMC therapy.
32 patients with primary surgery of pterygium were prospectively observed over a period of two years. The surgical removal was performed in bare-sclera excision. 24-48 hours postoperative MMC 0.02% eye drops were applied three times per day for five consecutive days. Than patients received local steroids (dexamethasone) twice per day for another week. Clinical examination and photography controls were performed six and twelve months after surgergy. This group of patients was compared to a retrospective group of 30 patients who were treated by bare-sclera excision without MMC (BS).
In one case, the MMC therapy had to be stopped on day three due to corneal thinning. Six patients complained about itching and redness during the MMC therapy and five patients showed the development of pseudomembranes. After the treatment with local steroids the pseudomembranen had vanished completely. Despite the intense postoperative antimetabolic therapy all patients recovered well from the intervention. In this group only two patients (6.3%) showed recurrence of pterygium over a follow-up period of two years. In the retrospective control group (BS) 14 patients with regrowing pterygium (46.7%) had been observed.
The postoperative application of MMC (0.02%) eye drops is an effective and safe strategy to prevent recurrence after surgical removal of pterygium. The described therapy was well tolerated and was associated with a low rate of recurrence after two years. To rule out potential long-term side effects of the local antimetabolic therapy further follow-up is required
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