COMPARISON OF PREOPERATIVE AND INTRAOPERATIVE MITOMYCIN C IN PREVENTION OF PTERYGIUM RECURRENCE AND POSTOPERATIVE COMPLICATIONS

Abstract

Objective: To compare the frequency of recurrence and corneoscleral complications with pre-operative and intraoperative mitomycin C when used with excision of primary pterygium by bare sclera technique in cases visiting eye department of Military Hospital Rawalpindi.
Study Design: Quasi experimental study.
Place of Study: Eye department of Military Hospital Rawalpindi, a tertiary care facility of armed forces.
Duration of Study: Ten months (October 2006 to July 2007).
Patients and Methods: A total of 70 cases with primary pterygium were selected and divided equally into group A and B. In cases of group A, 0.1cc of 0.15 mg/ml of MMC was injected sub-conjunctivally and pterygium excision with bare sclera technique was done 4 weeks later. In cases of group B, after removing the pterygium by bare sclera technique, a sponge soaked in 0.04% MMC was applied over the bare sclera for three minutes intraoperatively. The patients were followed up to see recurrence and corneoscleral complications for three months.
Results: A total of 70 cases, 35 in each group were analyzed statistically. Mean age of group A was 40.83 years (SD 12.655) whereas that of group B was 44.57 years (SD 13.718). Group A had 28 (80%) males and 7 (20%) females. Group B had 23 (65.7%) males and 12 (34.3%) females. Number of patients who presented with recurrence in group A was 1 (2.9%) and group B were 4(11.4%). In group A no patient presented with corneoscleral complications during the study whereas in group B these complications were 7(20%). Chi-square test revealed no significant difference in recurrence (p=0.356) whereas it showed significant difference in corneoscleral complications between the groups (p=0.011).
Conclusion: Preoperative MMC is as effective as intraoperative MMC in preventing recurrence but it is much safer than intraoperative MMC causing less corneoscleral complications.