Journal of the Korean Ophthalmological Society 2001;42(11):1535-1542.
Published online November 1, 2001.
Effect of Combined Therapy of Mitomycin C with Beta Irradiation for Prevention of Recurrence of Primary and Recurrent Pterygium.
Eui Ryun Chung, Jung Il Moon
Department of Ophthalmology, St. Mary's Hospital, School of Medicine, Catholic University of Korea.
원발 및 재발 익상편에서 재발 방지를 위한 Mitomycin-C 와 beta irradiation 의 복합치료법의 효과
문정일(Jung Il Moon),정의련(Eui Ryun Chung)
Abstract
PURPOSE
The most common problem in pterygium operation is recurrence ; recurrence rate is higher in recurrent pterygium than primary one. Effects on recurrence rate of combination therapy of intraoperative mitomycin C soaking method with postoperative beta-irradiation (strontium 90) along with its complications were investigated in primary and recurrent pterygium. Recurrence rate of the combination therapy was compared with that of the pterygium excision, postoperative beta-irradiation, and intraoperative mitomycin C soaking, respectively. METHODS: Fifty-three patients (fifty-nine eyes) with primary pterygium and twenty-three patients (twenty-four eyes) with recurrent pterygium received surgery. Mitomycin C in a concentration of 0.2 mg/ml soaked in a 2 x 2 mm Weckcel sponge was applied on the bare sclera intraoperatively after pterygium excision. Forty-five seconds of beta irradiation was done on the first and sixth postoperative days. RESULTS: During the mean follow-up period of 15 months, recurrence rate was 3.4% (2 eyes) in primary pterygium and 4.2% (1 eye) in recurrent one, respectively. Compared to the recurrence rate of 22.5% in primary and 35.0% in recurrent pterygium, respectively when removal of pterygium alone was performed and 14.3% in primary and 20.0% in recurrent, respectively with postoperative beta-irradiation and 12.8% in primary and 15.0% in recurrent, respectively with intraoperative mitomycin C soaking. These differences were statistically significant (P<0.05). One eye showed symblepharon in recurrent pterygium with combination therapy. CONCLUSION: Combination therapy of intraoperative administration of mitomycin C and postoperative beta irradiation (strontium 90) is considered an effective and safe adjunct for prevention of the recurrence of recurrent pterygium as well as primary.
Key Words: Pterygium;Recurrence;Mitomycin C;Beta-irradiation


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