Bare sclera pterygium surgery treated with different concentrations of mitomycin-C.

BACKGROUND: Pterygium, a non-cancerous growth of the clear, thin tissue over the white part of the eye is one of the major causes of eye problems in Zamboanga City. It is the most common finding among low income individuals who engage in outdoor livelihood activities such as fishing, farming, construction, and driving public transport vehicles. At present, there is a lack of consensus in the ophthalmological community on the optimal medical and surgical management of pterygium.

OBJECTIVE: To determine the effectivity of different concentrations of mitomycin C in the prevention of pterygium recurrence and post complication rate after bare sclera pterygium surgery among three treatment groups.

METHODS: A double-blind randomized study has been done to determine the recurrence and post-operative complication rate of 51 patients with pterygium exposed to three treatment groups after bare sclera pterygium excision. Treatment group A (n=19) was given 0.02% mitomycin C, group B (n=17) with 0.04% mitomycin C, and group C (n=15) placebo group (standard care). All respondents followed up for six weeks.

RESULTS: Post-operative data show recurrence of pterygium is highest in treatment group C with 40% of its subjects having signs of regrowth after the sixth week follow-up examination. Treatment group A on the other hand, shows no signs of recurrence but has the highest number of complications with 17.6% of the subjects manifesting scleral thinning. Finally, treatment group B shows a better result with neither incidence of recurrence nor complications in all its subjects.

CONCLUSION: It is highly recommended to use the 0.04% mitomycin C concentration after every pterygium surgery in the Zamboanga City Medical Center. To study the long term effects of this interventions, the author recommends further examination of post-operative patients several years after their surgeries.