Comparison between 0.02% Mitomycin C and Limbal Conjunctival Autograft as Adjuvant in Prevention of Pterygium Recurrence

Purpose: to compare the outcome of Mitomycin C (MMC) and limbal conjunctival autograft (LCAG) as adjuvant in the prevention of pterygium recurrence. Methods: Prospective study on consecutive cases of primary pterygium (February 2002 to March 2004) randomized into two adjuvant groups: (1) Intraoperative 0.02% MMC for 5 minutes or (2) LCAG. Patients were followed for recurrence (defined as fibrovascular tissue invading the cornea 1.5mm) and complications for a period of one year. Results: 60 eyes in 52 patients who completed the study were randomized to receive MMC (n = 32) and LCAG (n = 28). There were 5 recurrences (15.6%) in the MMC group and only one recurrence (3.6%) in the LCAG group. There was a statistically significant difference in the recurrence rate between the two groups (p = 0.04). There were a total of one conjunctival cyst, one symblepharon, two granulomas, and one dellen. No other visually significant complications were encountered in either group. Conclusion: Although LCAG resulted in better one year success rates, it is technically more difficult and inapplicable in cases with previous limbal disturbance. Simple excision followed by MMC or LCAG are both safe and acceptable adjuvant for pterygium excision. Choice of adjuvant should be carefully made based on assessment of recurrence risk, local practices, and surgeon s expertise.