Evaluation Of The Effectiveness Of Intra-Operative Mitomycin C For Pterygium Surgery In African Eyes

Abstract

Aims: This study was designed to evaluate Pterygium surgery and intra-operative mitomycin C application in Warri, Nigeria.
Methods: Case files of all patients who had pterygium surgery and intra operative application of 0.4 mg/ml of Mitomycin C; and were followed up for a minimum of 12months at DDS Eye Surgery in Warri, Nigeria between January 1998 – June 2002 were reviewed.
Results: One hundred and two eyes (87patients) had pterygium surgery and mitomycin C application intraoperatively. Fifteen eyes (14.7%) had recurrence after a minimum follow up period of 12 months. The male to female ratio was 1.4:1. The mean age of all the patients was 41.6 years. The mean age of the patients with recurrence was 39.6 years while that of the non-recurrence was 43.3 years. Main complications encountered were conjunctival granuloma thirteen (12.8%); delayed healing nine (8.8%); scleral melt three (2.9%). None of the eyes with delayed healing or scleral-melt had recurrence of their pterygium, but four out of thirteen eyes (31%) with conjunctival granuloma had recurrence of their pterygia. Use of native medication (cocktail of herbal extracts) and duration of pterygium before surgery had no bearing on recurrence. Most of the recurrences occurred between the 4th and the 6th months (73.3%).
Conclusion: Single intra-operative application of 0.4mg/ml of mitomycin C was found to be effective in reducing the incidence of recurrence of pterygium below 15% (14.7%) in African eyes. Ophthalmologists are advised to give patients the maximum benefit of pterygium surgery by using intra-operative mitomycin C.


Keywords: Pterygium recurrence, Post operative complications, Mitomycin C

Sahel Medical Journal Vol. 10 (4) 2007: pp. 132-136