Conjunctival limbal autograft versus simple excision with intra-operative mitomycin C in pterygium surgery: a comparative study

• Published in: Journal francais d'ophtalmologie Vol. 36; no. 3; p. 230
• Main Authors: Malek, I, Zghal, I, Chebbi, A, Lajili, Z, Boujemaa, C, Nacef, L, Bouguila, H, Saida Ayed, S
• Format: Journal Article
• Language: French
• Published: France 01.03.2013
• Subjects: Astigmatism - etiology; Astigmatism - surgery; Conjunctiva - transplantation; Female; Follow-Up Studies; Humans; Intraoperative Care; Male; Middle Aged; Mitomycin - administration & dosage; Mitomycin - therapeutic use; Postoperative Complications; Prospective Studies; Pterygium - complications; Pterygium - surgery; Recovery of Function; Recurrence; Reoperation; Severity of Illness Index; Transplantation, Autologous; Wound Healing
• ISSN: 1773-0597
• DOI: 10.1016/j.jfo.2012.03.017

The purpose of our study is to evaluate the long-term anatomical and functional results of conjunctival-limbal autograft (AGCL) compared to simple excision with intraoperative mitomycin C. We conducted a prospective comparative study of 60 eyes of 60 patients presenting with primary pterygium. These patients were divided into two groups, matched according to the age and the stage of the pterygium. Thirty eyes of 30 patients were treated with conjunctival limbal autograft (AGCL group), and 30 eyes of the other 30 patients were treated with simple excision with intraoperative mitomycin C (MMC group). Minimum follow-up was 24 months. The mean age of our patients was 50.6 and 51.3 years in the AGCL and MMC groups, respectively. A male predominance with male to female ratio of 1.5 was noted in both groups. We found more pterygium recurrences in the MMC group. Indeed, seven patients (23.3%) in the MMC group experienced a recurrence. In comparison, we found only a single recurrence (3.33%) in the AGCL group with a statistically significant difference (P=0.026). With regard to postoperative complications, we noted three inflammatory granulomas in the AGCL group (10%). In the MMC group, we observed two cases (6.66%) of delayed corneal healing with superficial punctate keratitis and epithelial defect and one case (3.33%) of symblepharon. There was no statistically significant difference in mean visual acuity gain between the two groups (AGCL: 1.76 lines; MMC: 2.82 lines; P=0.133). Pterygium surgery by excision with conjunctival limbal autograft is an effective technique offering a low rate of long-term recurrences and few complications.