1120-6721/153-04 $02.00/0 European Journal of Ophthalmology / Vol. 8 / no. 3, 1998 / pp. 153-156 © by Wichtig Editore, 1998 Intraoperative application of mitomycin C in the surgical treatment of pterygium A. DEMIROK, S. SIMSEK, A. ÇINAL, T. YASAR Yüzüncü Yil Üniversitesi Tip Fakültesi, Van - Türkey ABSTRACT: Purpose. To investigate the effectiveness of intraoperative mitomycin C in ptery - gium surgery. M e t h o d s . The effectiveness of intraoperatively administered mitomycin C and the occur - rence of postoperative complications were evaluated in 17 patients with two recurrences of pterygium. The authors employed the “bare-sclera technique” and placed a sterile sponge soaked in a 0.02% mitomycin C solution intraoperatively in the episcleral space for 3 min - utes. The control group (15 patients) underwent only surgical excision. Patients were followed for 21 to 30 months. Results. The pterygium recurred in one (5.9%) of the 17 patients in group 1 and in six (40%) of the 15 controls. Statistical analysis using Fisher’s exact test showed a significant (p=0.027) reduction of recurrences of pterygium in the group treated intraoperatively with mitomycin C. No serious complications or side effects arose during the follow-up period. Conclusions. Mitomycin C administered intraoperatively can be considered an effective treat - ment to improve the success rate after surgical excision. (Eur J Ophthalmol 1998; 8: 153-6) KEY WORDS: Pterygium, Mitomycin C, Recurrence I N T R O D U C T I O N Pterygium, a wing-shaped fibrovascular connective tissue overgrowth encroaching on the cornea, may cause a cosmetic blemish, ocular irritation, or visual impairment. Surgical treatment of pterygium is not a difficult procedure for the ophthalmologist but the re- currence rate after excision is quite high (30-50%) (1- 7) unless something is done at the time of excision. Postoperative beta-radiation has been reported to low- er the incidence of recurrence (8-11) but may lead to further complications such as scleral ulceration, cataract formation, and infection (11). Argon laser has been used to control very early blood vessel growth in the sclera and limbus to prevent pterygium recurrence fol- lowing surgery (12). Conjunctival autograft transplantation (13, 14) triethylene-thiophosphoramide (thio-tepa), an antimitotic, antimetabolite, alkylating, chemothera- peutic agent (15), have been used successfully. Mitomycin C is an antibiotic-antineoplastic agent that selectivity inhibits the synthesis of DNA, cellular RNA, and protein (16). In the last decade, a single int- raoperative dosage of mitomycin C has been used for glaucoma-filtering procedures and for pterygium surgery. In filtering procedures the rate of bleb failures has de- creased and the surgical outcome of previously failed filters has improved (17). No ocular surface-related complications of this procedure have been reported (16, 17). Mitomycin C has also been used in pterygium surgery. Postoperative use of 0.02% topical mitomycin C (0.2 mg/ml) or 1 mg/ml drops cut the recurrence rate of pterygium to a range of 2% to 11% (18-21). However, postoperative complications were reported even with a low dosage of mitomycin C (22). The major reasons for complications were related to uncontrolled and prolonged use of the drug by the patients (21). Oph- thalmologists are now considering the effectiveness of Accepted: October 20, 1997