Yulia Aziza1,2, Tsutomu Inatomi3,4, Chie Sotozono1, Shigeru Kinoshita5. 1. Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan. 2. Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. 3. Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan. tinatomi@koto.kpu-m.ac.jp. 4. Department of Ophthalmology, National Center for Geriatrics and Gerontology, Aichi, Japan. tinatomi@koto.kpu-m.ac.jp. 5. Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Abstract
PURPOSE: Numerous surgical methods, with varying rates of recurrence, have been applied for the treatment of pterygium. Adjuvant mitomycin C (MMC) application has shown promising results in the prevention of recurrence. Here we propose and describe modified bare sclera technique combined with the intraoperative application of MMC for pterygium excision. STUDY DESIGN: Retrospective study. METHODS: Primary pterygium patients who underwent pterygium excision via the bare sclera combined with 0.04% MMC technique from January 2014 to December 2016 were reviewed. In all patients, the subconjunctival pterygium strand was exposed and then sufficiently excised in combination with the safe use of MMC; i.e., the prevention of MMC dilution and diffusion to surrounding tissue. Surgical complications, recurrence rates, and recurrence onset were recorded. RESULTS: This study involved 32 primary pterygium eyes (grade T1 = 22 eyes; 68.7%). The mean postoperative follow-up period was 26.4 ± 14.5 months (range: 12-60 months). MMC was applied for 1-3 min. The mean complete epithelialization was 12.6 ± 7.6 days and no surgical complications were observed. In 1 patient with double-head primary pterygium, recurrence occurred at 15-months postoperative. CONCLUSIONS: The modified bare sclera technique combined with MMC application was found to be safe, effective, and presents good cosmetic appearance for the treatment of primary pterygium when safety points are strictly applied.
PURPOSE: Numerous surgical methods, with varying rates of recurrence, have been applied for the treatment of pterygium. Adjuvant mitomycin C (MMC) application has shown promising results in the prevention of recurrence. Here we propose and describe modified bare sclera technique combined with the intraoperative application of MMC for pterygium excision. STUDY DESIGN: Retrospective study. METHODS: Primary pterygium patients who underwent pterygium excision via the bare sclera combined with 0.04% MMC technique from January 2014 to December 2016 were reviewed. In all patients, the subconjunctival pterygium strand was exposed and then sufficiently excised in combination with the safe use of MMC; i.e., the prevention of MMC dilution and diffusion to surrounding tissue. Surgical complications, recurrence rates, and recurrence onset were recorded. RESULTS: This study involved 32 primary pterygium eyes (grade T1 = 22 eyes; 68.7%). The mean postoperative follow-up period was 26.4 ± 14.5 months (range: 12-60 months). MMC was applied for 1-3 min. The mean complete epithelialization was 12.6 ± 7.6 days and no surgical complications were observed. In 1 patient with double-head primary pterygium, recurrence occurred at 15-months postoperative. CONCLUSIONS: The modified bare sclera technique combined with MMC application was found to be safe, effective, and presents good cosmetic appearance for the treatment of primary pterygium when safety points are strictly applied.
Entities:
Keywords:
Bare sclera with MMC; Recurrence rate; Safety profile
Authors: Thiago Gonçalves Dos Santos Martins; Ana Luiza Fontes de Azevedo Costa; Milton Ruiz Alves; Roger Chammas; Paulo Schor Journal: Int J Ophthalmol Date: 2016-03-18 Impact factor: 1.779