Simple excision alone versus simple excision plus mitomycin C in the treatment of pterygium

BACKGROUND: Pterygium is a common ocular disorder throughout the world. The purpose of this study was to evaluate the efficacy of simple excision alone with or without topical mitomycin in the treatment of pterygium. PATIENTS AND METHODS: This study was performed in two stages. In the first stage, from 1991 to 1994, 100 patients (group 1) were operated on with simple excision and in the second stage, from 1995 to 1999, 300 patients (group 2) were treated with the same procedure plus topical mitomycin (0.02% eye drops four times a day for 4 days after operation). All cases were followed for 5 years. The recurrence rate of pterygium in these two treated groups were compared. RESULTS: The mean age of the subjects was 49 +/- 13 years in group 1 and 47 +/- 17 years in group 2. The clinical manifestations in these two groups were similar (P>0.05). After one year, relapse was seen in 21 cases (21 %) in group I and in 3 cases (1%) in group 2. After five years, 31 cases (31 %) in group 1 and 3 cases (1%) in group 2 had relapse (P=0.0001). The mean time to recurrence at five years for the simple excision group was 3.83 years (95% CI: 3.48 to 4.17 years) and for simple excision plus mitomycin C was 4.96 years (95% CI: 4.91 to 5.0 years) (P<0.0001). CONCLUSION: Instillation of mitomycin C eye drops appears to be safe in the treatment of pterygium.