Efficacy of Combined Use of Mitomycin C Intraoperatively and Conjunctival Autograft with Fibrin Glue in the Surgical Management of Primary Pterygia

Purpose: This study will evaluate the efficacy of combined intraoperative use of Mitomycin C and Conjunctival autograft with fibrin glue in the surgical Management of primary Pterygia. Methods: Fourteen patients with primary Pterygia were enrolled in this study. They had undergone pterygium excision with bare sclera technique followed by intraoperative Mitomycin C 0.02% application to the bare sclera using a medication-soaked filter paper for duration of two minutes with copious irrigation of the ocular surface by balanced salt solution. Finally conjunctival graft is fashioned and secured in place using fibrin glue. Patients: Were followed-up for a minimum of 8 months (mean, 13 months). The possible intraoperative, postoperative complications and recurrence rate were documented. Results: After a mean follow-up of 13 months, there were no recurrent cases. There were no intraoperative complications. Postoperative complications include early total graft dehiscence developed in 1 eye treated with repositioning with glue and suture and two cases of conjunctival cysts on the graft which required no intervention. Four cases suffered temporarily from excessive lacrimation, ocular pain and photophobia. No detectable serious-vision threatening complications like permanent conjunctival defects, scleral ulceration, scleral perfo-ration, iridocyclitis, glaucoma or cataract. The mean age of the patients was 36 years. Conclusion: Combined intraoperative use of Mitomycin C and Conjunctival autograft with fibrin glue in the surgical Management of primary Pterygia seems to be safe and effective method for prevention of postoperative pterygium recurrence. Certainly, larger numbers of patients with longer follow-up period is a must to assess the recurrence rate of this method.