Follow-Up After Bare Sclera Pterygium Excision and 0.10 ml of a 0.05 mg/ml of Preoperative Subconjunctival Mitomycin-C

Abstract

Purpose:: To evaluate the rate of recurrence and complications after subconjunctival injection of 0.10 ml of 0.05 mg/ml mitomycin-C approximately one-month prior to bare sclera pterygium excision.

Methods:: A retrospective review of 37 eyes of 34 patients who had pterygium excision from July 2005 to October 2006 at the John H. Stroger, Jr. Hospital of Cook County Division of Ophthalmology was conducted. The pterygia were excised using the bare sclera technique approximately 1 month after subconjunctival injection of 0.10 ml of 0.05mg/ml mitomycin-C. Standard post-operative medication regimine included neomycin and polymyxin B and dexamethasone drops four times a day. Our main outcome measures were recurrence of pterygium and related complications. Recurrence was defined as the reappearance of fibrovascular tissue greater than or equal to 1mm beyond the corneoscleral limbus.

Results:: Pterygia recurred in 10 of 37 eyes (27%) after an average follow-up time of 30 weeks (range 8 - 69 weeks). No patients had related complications.

Conclusions:: With limited follow-up, preoperative subconjunctival injection of 0.1 ml of 0.05mg/ml mitomycin-C prior to bare sclera pterygium excision appears to be a safe treatment. However, there was a higher rate of recurrence (27%) compared to a similar group of patients we studied using 0.1 mg/ml subconjunctival mitomycin-C (4.3%). Longer follow-up is needed to assess both the safety and efficacy of this procedure.

Keywords: Pterygium • cornea: clinical science • clinical (human) or epidemiologic studies: outcomes/complications