A Clinical Study of Pterygium and Results of Treatment by Excision and Limbal Autograft or Augmented with Post-Op Mitomycin C

Achyut N. Pandey, Nishant Marken, Ravinder Marken, Bhuwan Chandra Pandey

Department of Ophthalmology, VCSG Government Medical College and Research Institue, Srinagar Garhwal, India;.
Narayan Netralaya, Srinagar Garhwal, Uttarakhand.
Ravi Eye Hospital, Bhawanigarh, Punjab;.

DOI: 10.4236/ojoph.2013.34023                

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.

Keywords

Pterygium; Autograft; Mitomycin C; Vascularisation

Conflicts of Interest

The authors declare no conflicts of interest.

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