Pterygium surgery with mitomycin and tarsorrhaphy

Thomas O. Wood, Ellen E. Williams, Danielle L. Hamilton, Bryan L Williams, Edward J. Holland, George L. Spaeth, George O. Waring, Allan J. Flach

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To determine if a pterygium surgical procedure consisting of minimal conjunctival removal, excision of the hypertrophic subconjunctival fibrovascular tissue, application of mitomycin 0.25 mg/mL for 1 minute combined with temporary nasal tarsorrhaphy, and use of postoperative dexamethasone/ antibiotic drops achieves the following: safely simplifies pterygium removal, controls the early side effects of mitomycin, reduces the rate of recurrence, and lessens the need for conjunctival transplantation. Methods: Twenty eyes in 19 patients underwent the procedure with use of mitomycin; 15 eyes had primary and 5 had recurrent pterygia. These were compared with a previous group of 28 eyes in 26 patients that underwent pterygium/tarsorrhaphy surgery without use of mitomycin; 20 eyes had primary and 8 had recurrent pterygia. Postoperatively, all eyes in both groups were treated with dexamethasone/antibiotic drops. Results: In the mitomycin group, with an average follow-up of 12.1 months, 19 eyes healed uneventfully; there have been no recurrences. The nonmitomycin group, with an average follow-up of 42.6 months, has had nine recurrences (32%); four required a second procedure. Recurrence was significantly lower in the mitomycin group (P = .006). Conjunctival healing, as reflected in the time from surgery until tarsorrhaphy opening, was significantly delayed in the mitomycin group, 36.7 versus 17 days (P = .001). The delay in conjunctival healing may explain the complications associated with the use of mitomycin in pterygium surgery. Conclusion: Minimal conjunctival removal, extensive fibrovascular tissue excision, 1-minute application of mitomycin 0.25 mg/mL, temporary nasal tarsorrhaphy, and frequent application of dexamethasone/antibiotic drops postoperatively provided a safe and successful approach to pterygium management in this series.

Original languageEnglish (US)
Pages (from-to)108-115
Number of pages8
JournalTransactions of the American Ophthalmological Society
Volume103
StatePublished - Dec 1 2005

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Pterygium
Mitomycin
Dexamethasone
Recurrence
Anti-Bacterial Agents
Nose
Minimally Invasive Surgical Procedures
Transplantation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wood, T. O., Williams, E. E., Hamilton, D. L., Williams, B. L., Holland, E. J., Spaeth, G. L., ... Flach, A. J. (2005). Pterygium surgery with mitomycin and tarsorrhaphy. Transactions of the American Ophthalmological Society, 103, 108-115.

Pterygium surgery with mitomycin and tarsorrhaphy. / Wood, Thomas O.; Williams, Ellen E.; Hamilton, Danielle L.; Williams, Bryan L; Holland, Edward J.; Spaeth, George L.; Waring, George O.; Flach, Allan J.

In: Transactions of the American Ophthalmological Society, Vol. 103, 01.12.2005, p. 108-115.

Research output: Contribution to journalArticle

Wood, TO, Williams, EE, Hamilton, DL, Williams, BL, Holland, EJ, Spaeth, GL, Waring, GO & Flach, AJ 2005, 'Pterygium surgery with mitomycin and tarsorrhaphy', Transactions of the American Ophthalmological Society, vol. 103, pp. 108-115.
Wood TO, Williams EE, Hamilton DL, Williams BL, Holland EJ, Spaeth GL et al. Pterygium surgery with mitomycin and tarsorrhaphy. Transactions of the American Ophthalmological Society. 2005 Dec 1;103:108-115.
Wood, Thomas O. ; Williams, Ellen E. ; Hamilton, Danielle L. ; Williams, Bryan L ; Holland, Edward J. ; Spaeth, George L. ; Waring, George O. ; Flach, Allan J. / Pterygium surgery with mitomycin and tarsorrhaphy. In: Transactions of the American Ophthalmological Society. 2005 ; Vol. 103. pp. 108-115.
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abstract = "Purpose: To determine if a pterygium surgical procedure consisting of minimal conjunctival removal, excision of the hypertrophic subconjunctival fibrovascular tissue, application of mitomycin 0.25 mg/mL for 1 minute combined with temporary nasal tarsorrhaphy, and use of postoperative dexamethasone/ antibiotic drops achieves the following: safely simplifies pterygium removal, controls the early side effects of mitomycin, reduces the rate of recurrence, and lessens the need for conjunctival transplantation. Methods: Twenty eyes in 19 patients underwent the procedure with use of mitomycin; 15 eyes had primary and 5 had recurrent pterygia. These were compared with a previous group of 28 eyes in 26 patients that underwent pterygium/tarsorrhaphy surgery without use of mitomycin; 20 eyes had primary and 8 had recurrent pterygia. Postoperatively, all eyes in both groups were treated with dexamethasone/antibiotic drops. Results: In the mitomycin group, with an average follow-up of 12.1 months, 19 eyes healed uneventfully; there have been no recurrences. The nonmitomycin group, with an average follow-up of 42.6 months, has had nine recurrences (32{\%}); four required a second procedure. Recurrence was significantly lower in the mitomycin group (P = .006). Conjunctival healing, as reflected in the time from surgery until tarsorrhaphy opening, was significantly delayed in the mitomycin group, 36.7 versus 17 days (P = .001). The delay in conjunctival healing may explain the complications associated with the use of mitomycin in pterygium surgery. Conclusion: Minimal conjunctival removal, extensive fibrovascular tissue excision, 1-minute application of mitomycin 0.25 mg/mL, temporary nasal tarsorrhaphy, and frequent application of dexamethasone/antibiotic drops postoperatively provided a safe and successful approach to pterygium management in this series.",
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