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Preoperative sub-pterygeal injection, intraoperative topical Mitomycin C for pterygium subpterygeal injection and intraoperative topical Mitomycin C for pterygium removal: comparison of recurrence rate and complications - randomised control study

Poster Details

First Author: K.Lavanya INDIA

Co Author(s):    K. Babu   R. Srinivasan   S. Chikkabasavaiah        

Abstract Details



Purpose:

To study and compare the effects of Preoperative Subpterygeal injection and Intraoperative topical Mitomycin C on Recurrence rates and Complications for primary pterygium excision.

Setting:

Study was conducted at JIPMER, Pondicherry an institute of national importance situated at India.

Methods:

Sixty patients with primary pterygium attending ophthalmology OPD were enrolled in the study group. They are divided into 2 Groups, 30 in Group A- Preoperative subpterygeal injection of 0.01%MMC and bare sclera, Group B- Intraoperative topical 0.02%MMC and conjunctival autograft with fibrin gluePulse rate and Blood pressure were measured for all subjects. Intra ocular pressure (IOP) was measured using Non Contact Tonometer. 90D and Direct ophthalmoscopic examination of dilated fundus was done for all patientsRisk of complications and recurrence rate were assessed between the 2 groups. There was no statistically significant difference between the 2 study groups. No sight threatening complications like sclera thinning and perforation or corneal dellen were noted in follow up period.

Results:

The complication rate between study groups is not statistically different since P value is >0.05. According to fisher's exact test, P value is 0.25. 95% Confidence limits is (0.03-1.82). Five cases of superficial punctuate keratitis , two in group A and three in group B. All of them resolved by one month. One case of subconjunctival haemorrhage was noted in group B, which resolved by 2 weeks. one case of graft displacement was noted on postoperative day one which was sutured and secured in place. One case of pyogenic granuloma was noted in group B, which resolved completely with three weeks of topical steroids. Among 60 patients, 38 were followed up for one year, 20 in group A and 18 in group B and remaining 22 were followed for six months. There was only one recurrence (3.3%) in the third month in group B, and no recurrence in Group A. The difference in recurrence rate is not statistically significant between study groups (P=0.5, fisher exact test). There was statistically significant improvement in BCVA, schirmers, keratometry, TBUT following pterygium excision.

Conclusions:

Preoperative Subpterygeal Injection is as effective as Intraoperative Topical Mitomycin C in preventing Recurrence rate and Complications for primary pterygium excision. FINANCIAL INTEREST: NONE

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