TITLE:
A Clinical Study of Pterygium and Results of Treatment by Excision and Limbal Autograft or Augmented with Post-Op Mitomycin C
AUTHORS:
Achyut N. Pandey, Nishant Marken, Ravinder Marken, Bhuwan Chandra Pandey
KEYWORDS:
Pterygium; Autograft; Mitomycin C; Vascularisation
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.3 No.4,
October
14,
2013
ABSTRACT: Aim: To prospectively analyze the clinical
profile of pterygium and to compare results of management by excision with limbal
conjunctival autograft or postoperative topical Mitomycin C drops. Methodology: Study was conducted over a period of
23 months, at a tertiary eye care hospital including 80 eyes of 80 patients who
underwent surgery, out of which 40 underwent limbal conjunctival autograft and
the remaining 40 underwent pterygium excision followed by Mitomycin C after
fulfilling the inclusion criteria. A detailed history was taken and recorded
regarding the disease with reference to age, occupation, residence, exposure to
dust and hot wind. The extent of corneal involvement by the pterygium was
noted. The patients were followed after one week and then monthly for a year.
BCVA were noted on every visit and slit lamp examination was done for
recurrence, sclera thinning and corneal vascularisation. Result: 80 eyes of 80 patients were enrolled
with male preponderance, out of which 40 underwent limbal conjunctival
autograft (gr. A) and the remaining 40 underwent pterygium excision followed by
Mitomycin C (gr. B). All patients were in the age group of 23 to 70 years. The
study showed a higher incidence of pterygium in the age group of 41-50 years with male preponderance
probably due to chronic dryness, and exposure to ultraviolet light, dust, and
hot winds. The right eye was more affected than the left eye, and nasal side
was more involved than the temporal side. The recurrence among group A was 2
out of 40 with a recurrence rate of 5% and among group B was 3 out of 40 with a
recurrence rate of 7.5%. Scleral thinning was seen in two cases (5%) in
patients who underwent pterygium excision followed by Mitomycin C. Conclusion: Conjunctival limbal autograft and
postoperative MMC (0.02%) are both safe and effective adjuncts to primary
pterygium surgery. The main prejudices against autografting are the expertise
and time required for the procedure. The recent use of biologic adhesives to
fixate the autograft in place may simplify the procedure. Age of the patients
was strongly associated with recurrence regardless of which procedure was used. More research needs to be done to delve into this
seemingly innocuous pathology of conjunctiva to effectively manage the disease
condition.