PT  - JOURNAL ARTICLE
AU  - Tsim, Nicole C
AU  - Young, Alvin L
AU  - Jhanji, Vishal
AU  - Ho, Mary
AU  - Cheng, Lulu L
TI  - Combined conjunctival rotational autograft with 0.02% mitomycin C in primary pterygium surgery: a long-term follow-up study
AID  - 10.1136/bjophthalmol-2014-305817
DP  - 2015 Oct 01
TA  - British Journal of Ophthalmology
PG  - 1396--1400
VI  - 99
IP  - 10
4099  - http://bjo.bmj.com/content/99/10/1396.short
4100  - http://bjo.bmj.com/content/99/10/1396.full
SO  - Br J Ophthalmol2015 Oct 01; 99
AB  - Background/aims To compare the long-term outcomes of primary pterygium surgery with combined conjunctival rotational autograft and mitomycin C (CRA-MMC), mitomycin C alone (MMC) and limbal conjunctival autograft (LCAU).Methods The outcomes of primary pterygium excision followed by conjunctival rotational autograft (CRA) combined with intraoperative 0.02% MMC for 5 min (group 1, CRA-MMC, n=61) were compared with historical control groups consisting of, pterygium excision with MMC (group 2, n=47), and, pterygium excision with limbal conjunctival autograft (LCAU) (group 3, n=29). The main outcome measures were recurrence rate and complications.Results The mean follow-up period was 101±3 months, 138±2 and 137±2 months in the CRA-MMC, MMC and LCAU groups respectively. Recurrence was noted in one patient (1.6%) in the CRA-MMC, 12 patients with MMC (25.5%) and 2 patients with LCAU (6.9%). The difference in recurrence rate between CRA-MMC and MMC was statistically significant (p<0.001). Early postoperative complications included 3 conjunctival cysts (1 from the CRA-MMC, 2 with MMC alone), 2 symblephara (1 in the MMC group, 1 in the LCAU group), and 1 granuloma in the CRA-MMC group.Conclusions Pterygium excision followed by CRA-MMC or LCAU are effective means of preventing recurrence. The use of CRA-MMC in pterygium excision may be considered for cases where conventional autograft harvesting is contraindicated or when large grafts for double-head pterygium are required.