Outcome of double-headed pterygium surgery

Purpose. To evaluate the postoperative outcome and recurrence rate of bare sclera technique combined with intraoperative application of mitomycin C (MMC) 0.02% for 5 minutes in the treatment of primary and recurrent double-head pterygia. Methods. A prospective, noncomparative interventional case series of 13 eyes in 13 patients with primary (n = 10) or recurrent double-head pterygia in one eye operated on by one surgeon (R.A.). They all had bare sclera excision combined with intraoperative application of MMC 0.02% for 5 minutes. All patients were followed postoperatively for recurrence of the lesion, aesthetic outcome, and incidence of eye complications. Results. Mean follow-up was 36.3 ± 3.8 months for the patients with primary and 28.4 ± 2.7 months for the patients with recurrent double-head pterygia. There was only one recurrence in one of the three eyes in the group with recurrent pterygia (33.33%). The only significant complication observed was a pyogenic granuloma in two of the recurrent and one of the primary cases. Conclusions. The bare sclera technique combined with intraoperative MMC 0.02% for 5 minutes is an effective and safe procedure for double-head pterygia. This method can serve as a useful alternative to amniotic membrane transplantation in countries where the latter is not available and in patients in whom conjunctival autograft is not feasible.