Comparing Adjuvant Beta Radiation, Mitomycin C, and Conjunctival Autograft in Primary Pterygium Treatment, a Three-year Follow-up Study



Khalil M. Al-Salem1, *, Ahmad T.S. Saif2, Passant S. Saif3
1 Department of Ophthalmology and Visual Sciences, Mutah University, Al-Karak, Jordan
2 Department of Ophthalmology, Fayoum University, Fayoum University Hospital, Fayoum, Egypt
3 Department of Ophthalmology, Misr University for Science and Technology, Giza, Egypt


© 2020 Al-Salem et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology and visual sciences, Mutah University, Al-Karak, Box: 830910, Amman, Jordan; Tel: 00962797262600; E-mail: khalil_alsalem@hotmail.com


Abstract

Purpose:

To compare the recurrence rate of primary pterygium surgery after the adjuvant use of Beta radiation, Mitomycin C, and conjunctival autograft.

Methods:

180 eyes of 180 patients were included in the study. All cases had primary pterygium excision following the use of adjuvant therapy of Beta radiation or Mitomycin C (0.02% for 5 minutes) or conjunctival autograft. The study was conducted at Fayoum University Hospital, Fayoum, Egypt, and Misr University Hospital. The patients were randomly divided into three groups, with each group comprising 60 patients. Group (A) included patients treated with Beta radiation following Pterygium excision, group (B) patients had primary pterygium excision with the application of 0.02% Mitomycin C for 5 minutes, and group (C) patients had conjunctival autograft to cover the bare area after pterygium excision. Patients were followed up for three years postoperatively.

Results:

group A had the highest recurrence rate (33.3%) followed by group B (13.3%), and finally group C presented a recurrence rate of 6.7%. Group B showed the highest rate of intra-ocular postoperative complications, while no intra-ocular complications were recorded in group C. Common complications in groups A and B were scleral melting, keratitis, and Dellen formation.

Conclusion:

Using conjunctival autograft after primary pterygium excision gives the best results regarding the rate of recurrence and postoperative complications. Meanwhile, B-radiation or Mitomycin C did not prove to be as good.

Keywords: Pterygium surgery, Adjuvant use of Mitomycin C, Beta radiation, Conjunctival Autograph, Conjunctival flap, Recurrence rate, Pterygium surgery complications.