Incidence of dry eye, refractive error changes and recurrence rate in the management of pterygium by conjunctival auto grafting with or without mitomycin – C in a tertiary eye care center

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Original Article

Author Details : Piyali Sarkar, Malsawmtluanga, Kumaresh Chandra Sarkar

Volume : 3, Issue : 2, Year : 2017

Article Page : 116-121

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Abstract

Objectives: To compare dry eye changes, refractive error changes and recurrence rate of pterygium between the two techniques of conjunctival autografting and conjunctival autografting with intra operative application of mitomycin-c.
Materials and Methods: It was a hospital based prospective, randomized, interventional comparative study of 40 eyes of 38 patients among whom 20 eyes underwent pterygium excision with conjunctival autografting (group A) and rest 20 eyes underwent pterygium excision with conjunctival autografting and intra operative application of mitomycin-c (group B). The preoperative and postoperative one month Schirmer I test, tear film break up time (TBUT), best corrected visual acuity, spherical error and astigmatism were noted. They were followed up for six months and observed for recurrence of the pterygium. Statistical analyses were used to compare the two groups.
Results: 38 patients (40 eyes) diagnosed with primary pterygium were evaluated. 20 eyes with pterygium were treated with conjunctival autografting and 20 eyes with conjunctival autografting combined with intra operative application of mitomycin-c (0.02% for two minutes). At postoperative one month, there were one positive Schirmer I test in group A and two positive in group B which were not significant on comparison (p=1.000). There were three positive TBUT test in group A and one positive TBUT test in group B which was not significant (p=0.598).
For changes in astigmatism, 10 cases improved, seven cases showed no changes and 3 cases worsened in group A. In group B, 12 cases improved, seven cases showed no changes and one case worsened. On comparing the two groups it was statistically not significant (p=0.541). For spherical error changes, six cases improved, 11 cases showed no change and three cases worsened in group A. In group B, 5 cases improved, 10 cases showed no change and 5 cases worsened which was not significant (p=0.725). For BCVA(Best corrected visual acuity) change, 11 cases improved, 7 cases showed no change and 2 cases worsened in group A. In group B, there were 10 cases which improved and 10 cases showed no change. On comparing the two results, p = 0.187 which is not significant. There was a 5% recurrence rate (one eye) from the conjunctival autograft group. There were no significant difference in the rate of recurrence (p=1.000) between the 2 groups. No mitomycin-c related complication was observed during the length of the study.
Conclusion: Intra operative application of mitomycin-c does not induce dry eye. On refractive error changes, based on visual acuity, astigmatism and spherical error, there is no difference of outcome on using intra operative mitomycin-c. Conjunctival autograft surgery alone for primary pterygium is effective and safe in reducing the rate of recurrence of pterygium within six months.

Keywords: Pterygium, Refractive error changes, Recurrence, Conjunctival autografting, Mitomycin-C

How to cite : Sarkar P, Malsawmtluanga, Sarkar K C, Incidence of dry eye, refractive error changes and recurrence rate in the management of pterygium by conjunctival auto grafting with or without mitomycin – C in a tertiary eye care center. IP Int J Ocul Oncol Oculoplasty 2017;3(2):116-121

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