Abstract
Abstract: :
Purpose:To evaluate the long term effects of intra-operative application of mitomycin C on the scleral thickness and the conjunctival epithelium at the surgical site of pterygium excision. Methods:A prospective evaluation of 10 patients who had excision of primary pterygium 5 years previously. Patients were examined by slit-lamp biomicrospcopy, impression cytology, and high-frequency ultrasound. Impression cytology was performed by applying a small nitrocellulose filter paper for a few seconds at 3 sites, respectively: the excision area, the opposite perilimbal area (nasal or temporal), and the superior bulbar perilimbal conjunctiva for a few seconds, then placing the paper in a fixative solution, and subjecting it to a previously described staining protocol. The morphology of the conjunctival epithelium and goblet cell density were recorded. High frequency ultrasound was performed at the same sites, at the perilimbal area. The scleral thickness was measured at a distance of 1 mm from the limbus. Results:All patients had a successful result with no recurrence. Impression cytology revealed a paucity of normal conjunctival epithelial cells at the excision area, with rare goblet cells, while a normal conjunctival cell population was demonstrated at the other sites. No differences were noted between the scleral thickness at the operated site (0.75mm 0.07mm) and the opposite site (0.74mm 0.08mm) (p=0.8). Conclusion:A single application of Mitomycin C at the time of pterygium excision is not associated with reduction in scleral thickness five years post-operatively. A normal conjunctival epithelium does not recover at the pterygium excision site.
Keywords: 532 Pterygium • 574 sclera • 369 cornea: clinical science