Randomized trial of intraoperative mitomycin C in surgery for pterygium

PURPOSE: To report the efficacy and safety of intraoperative application of mitomycin C in surgery for pterygium. METHODS: Tn a prospective randomized and double blind study done within a span of 2.5 years in 50 eyes (50 patients) with primary progressive pterygium, mitomycin C in a concentration of 0.02 mg/ml soaked in a sterile 5 x 5-mm sponge was applied over the bare sclera intraoperatively as an adjuvant therapy in 25 eyes after pterygium excision. These cases were compared with another 25 similar eyes that underwent the same procedure but in which gentamicin solution 0.3% was used instead of mitomycin C solution. RESULTS: Three eyes (12%) in the mitomycin C group showed recurrence within 7 months of surgery compared with eight eyes (32%) of the gentamicin control group within 3 to 5 months. Mild side effects, such as pain, photophobia, and delayed wound healing, were observed within the first 1 to 2 weeks postoperatively in both groups. In the mitomycin C-treated group, corneal changes in the form of superficial punctate keratitis (three eyes) and limbal avascularity (two eyes) subsided within 2 weeks postoperatively. Follow-up time for these cases ranged from 18 to 21 months. CONCLUSIONS: A diluted solution of mitomycin C, 0.02 mg/ml, with an accurate size of sterile sponge applied to bare sclera after primary pterygium excision decreases the rate of recurrence to a greater extent than does gentamicin solution and is not associated with severe complications.