Combined mitomycin C application and free flap conjunctival autograft in pterygium surgery

Purpose: To evaluate the long-term postoperative outcome and complication rate of combined intraoperative low-dose mitomycin C application and free conjunctival autograft for the treatment of pterygium. Methods: In a prospective, consecutive, noncomparative case series, a series of 46 consecutive patients (50 eyes) with primary pterygium (43 eyes) or recurrent pterygium (7 eyes) were studied. The patients' ages ranged from 23.0 to 80.0 years (mean, 53.4 years). All patients underwent pterygium excision combined with intraoperative low-dose mitomycin C application (0.02% for 2 minutes) and free conjunctival autograft. The mean follow-up period was 29.2 months (range 12 to 41 months). The main outcome measures were recurrence of pterygium and postoperative complications. Results: Pterygium recurred to a small extent (0.5 mm) in one eye (2%) of a patient with recurrent pterygium. There were no intraoperative complications. Subconjunctival graft hematoma appeared soon after surgery and resolved spontaneously in five eyes (10%). One eye developed transient high intraocular pressure without optic nerve or visual field defect, and one eye developed mild symblepharon. There were no sight-threatening complications or serious side effects. Conclusions: By applying a single low dose of mitomycin C combined with free conjunctival autograft during pterygium excision, the recurrence rate of pterygium can be markedly reduced.