Effectiveness of subconjunctival mitomycin-C compared with subconjunctival triamcinolon acetonide on the recurrence of progresive primary pterygium which underwent Mc Reynolds method

Abstract

Background: The main problem in the management of pterygium is how to diminish the recurrence rate
after surgical treatment. Mitomycin-C an antineoplastic, antifibrotic has been used to prevent recurrence
rate of pterygium after excision, however, it correlated with some complications. Subconjunctival
administration before excision has been proposed to avoid them.
Objective: To know the effectivity of subconjunctival of mitomycin-C to decrease the recurrence rate of
progresive primary pterigyum after Mc Reynold method compared with subconjunctival triamcinolon
acetonide.
Materials and methods: Randomized clinical trial of 41 progresive primary pterygium in Dr Sardjito Hospital
and Dr Yap Eye Hospital. They were randomly assigned to receive subconjunctival 0.1 ml triamcinolon
acetonide or 0.1 ml mitomycin-C and underwent pterygium excision one week later using Mc Reynold
method. The follow up period was 6 months to detect any recurrence and complication of the drugs
Results: The recurrence rate after subconjunctival mitomycin-C and triamcinolon acetonide was 4.7% and
25%, respectively, however the different was not statistically significant (p=0.67). There were no
statistical difference in conjunctival hiperemia, lacrimation and granulation. Blepharospasm was significantly
different in seven days. The pain after injection and after excision was statistically different between two
two groups.
Conclusion: The recurrence rate of progressive primary pterygium in triamcinolon acetonide group was
higher than mitomycin-C group but there was no statistical difference.
Key words : Progressive primary pterygium – mitomycin-C – triamcinolon acetonide – Mc Reynold method