Intraoperative and postoperative use of mitomycin-C in the treatment of primary pterygium

BACKGROUND AND OBJECTIVE: The effectiveness of 0.04% mitomycin-C either postoperatively for 2 weeks or intraoperatively as a single dose, as an adjunct in the surgical treatment of primary pterygium was evaluated. PATIENTS AND METHODS: Mitomycin-C was used in addition to the bare sclera technique in 43 eyes with pterygia. The mean follow-up time was 18.5 months for the 24 eyes in the postoperative mitomycin-C group, 10.3 months for the 19 eyes in the intraoperative mitomycin-C group, and 17.3 months for the 17 eyes in the control group (eyes that had undergone surgical excision only). RESULTS: The recurrence rate was 4.2% with postoperative administration, 5.3% with intraoperative application, and 41.2% in the control group. There was a significant reduction in recurrence rates for both the postoperative and the intraoperative mitomycin-C groups compared with the control group (P = .005 and P = .01, respectively). However, recurrence rates were not statistically different according to the type of application. No serious side effect occurred during the follow-up period. CONCLUSION: Topical mitomycin-C either intraoperatively or postoperatively, as an adjunct decreases the recurrence rate of primary pterygium. Intraoperative application seems advantageous because it decreases the symptomatic side effects and restricts the inappropriate use by the patient.