Intraoperative mitomycin C to prevent recurrence of pterygium after excision: A 30-month follow-up study

Objective: The purpose of the study was to examine the efficacy of intraoperative mitomycin C (MMC) in preventing recurrence of pterygium after excision and the postoperative complications encountered. Design: The study design was a prospective, randomized, clinical trial. Participants: A total of 180 primary and recurrent pterygia were recruited for the study. They were randomized into five groups: A, control with no MMC; B, 0.02% MMC for 5 minutes; C, 0.04% MMC for 5 minutes; D, 0.02% MMC for 3 minutes; and E, 0.04% MMC for 3 minutes. Intervention: All patients received pterygium excision with or without the above four modes of intraoperative MMC application. Main Outcome Measures: Recurrence of pterygium and postoperative complications such as superficial scleral melting were measured. Results: At a mean follow- up of 30 (groups A-C) and 20 months (groups D and E), the respective recurrence rates in groups A through E were 75%, 8.3%, 8.6%, 42.9%, and 22.9%. There were two cases of postoperative superficial scleral melting in group C. Otherwise, no major postoperative complications were encountered. Conclusions: The midterm results of a single intraoperative application of MMC at the concentration of 0.02% for 5 minutes are encouraging. Its application as an adjunctive therapy for the surgical treatment of pterygium appeared to be safe and effective. However, because of the possibility of serious late complications, the authors suggest that this procedure be reserved for patients who have high probability of recurrence after excision of pterygium.