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K. Hotta, J. Hotta, J. Uchida, J. Ishigaki, M. Iwakawa, R. Yokota, Y. Yokoyama, Y. Ono; Effects of Mitomycin C in Pterygium Surgery on Corneal Endothelium and Blood-Aqueous Barrier Function. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5299.
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To evaluate the effects of intraoperative application of mitomycin C (MMC) on the corneal endothelium and blood-aqueous barrier function at the surgical site of pterygium excision.
Nonrandomized, retrospective, comparative case series. A total of 46 patients were included in the study. Twenty-six eyes of 25 patients (MMC group) received MMC (0.2 mg/ml for 5 minute) with pterygium excision. Controls were 21 eyes of 21 patients who received pterygium excision alone. All patients had primary (first-occurrence) pterygium excised with or without MMC adjunct. Pre- and postoperatively, specular microscopy was used to count the corneal endothelial cells for up to 6 months after the operation. Flare values were also determined as a measure of aqueous protein concentration.
Mean central cell density of the MMC group and control group at 1 month, 3 months, 6 months after treatment was decreased by 99.9 ± 4.5 %, 98.3 ± 4.0%, 99.9 ± 6.4 % and 98.7 ± 4.6 %, 99.1 ± 5.4 %, 96.4 ± 6.8 % compared with preoperative values, respectively. No significant difference was observed at any time after treatment. Mean flare value of the MMC group and control group at pre-, 1, and 7 days after treatment was; 9.0 ± 5.7, 18.4 ± 16.8, 10.6 ± 7.0 pc/msec and 9.8 ± 6.5, 34.4 ± 26.4, 11.2 ± 8.0 pc/msec, respectively. The mean flare value of the MMC group at 1 day was significantly lower (p < 0.05) than the control group.
A single application of MMC during pterygium excision is not associated with reduction in corneal endothelial cells more than 6 months postoperatively. The blood-aqueous barrier function retains its normal levels, with a marked reduction of the early postoperative inflammation compare to the cases without MMC.
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