Title: A novel approach to prevent Pterygium recurrence

Abstract

Objective: To evaluate the impact of the different doses and duration of mitomycin C (MMC) on the pterygium surgery outcome. Introduction: The pterygium is one of the common ocular surface diseases; no actual pathogenesis had been described. No medical therapy for pterygium available; therefore, the only treatment is surgical removal, which might end with recurrence; to prevent this mitomycin C (MMC) used. Till now, the ideal duration of MMC exposure remained questionable. This study shows the effect of different doses and duration on the pterygium surgery outcome. Subjects and method: It is an observational retrospective study that comprised of a total of 144 subjects, had been divided into three groups, each group consisting of 48 patients who underwent pterygium surgery with MMC and graft. All groups had received the same postoperative treatment. Results: The incidence of recurrence was 13.5% among all the groups, of which 12.5% for group B and 0.7% for group A and no recurrence in Group C. The p-value= 0.000. The recurrence was more among males with non-significant p-value=0.5 and more among > 50 years of age with highly significant p-value=0.000. The incidence of stromalysis was 0.71%. Conclusion: This study emphasizes that the shorter the duration (just washing) of MMC, the better the protection against scleral stromalysis, but the lower the dose, the higher the recurrence rate. Therefore, much more workup requires for setting up a customized surgical procedure, to achieve utmost preventive criteria for both recurrence and stromalysis.

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