Effectiveness of Mitomycin C Combined with Amniotic Membrane Transplantation to Treat Recurrent Pterygia

Young Hoon Jung; Byung Yi Ko

doi:10.3341/jkos.2018.59.3.217

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Jung and Ko: Effectiveness of Mitomycin C Combined with Amniotic Membrane Transplantation to Treat Recurrent Pterygia

Original Article

J Korean Ophthalmol Soc 2018;59(3):217-222.

Published online: 7 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.3.217

Effectiveness of Mitomycin C Combined with Amniotic Membrane Transplantation to Treat Recurrent Pterygia

Young Hoon Jung, MD, Byung Yi Ko, MD, PhD

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea

Address reprint requests to Byung Yi Ko, MD, PhD Department of Ophthalmology, Konyang University Hospital, #158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: 82-42-600-9258, Fax: 82-42-600-9251, E-mail: kopupil@hanmail.net

Received 14 December 2017 Revised 9 January 2018 Accepted 19 February 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated a combination of intraoperative mitomycin C (MMC) and amniotic membrane transplantation (AMT) for treating recurrent pterygia.

Methods

We retrospectively analyzed 40 eyes of 39 patients with recurrent pterygia who underwent AMT from December 2007 to July 2015 and who were followed-up for a minimum of 12 months. In all, 22 eyes received intraoperative MMC (group A) and 18 did not (group B). Recurrence rates and complications were compared between the two groups.

Results

Conjunctival recurrence was noted in two and corneal recurrence was noted in four eyes of group A (27.3%); the figures for group B were four and three (38.9%). These recurrence rates were not significantly different (p = 0.545). In five cases with preoperative symblepharon, this condition recurred when MMC was not used (two eyes) but not when MMC was used (three eyes). No major complications such as necrotizing scleritis, scleromalacia, or corneal ulcer were observed in either group after surgery.

Conclusions

Intraoperative adjunct MMC therapy did not significantly inhibit recurrence after AMT for treating recurrent pterygia but may reduce the recurrence rate of symblepharon.

Keywords: Amniotic membrane transplantation, Mitomycin C, Recurrent pterygium, Symblepharon

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Figure 1.

Classification of recurrence. (A) grade 2; fibrovascular tissue growing in the excised area, not invading the cornea (conjunctival recurrence). (B) grade 3; fibrovascular tissue invading the cornea (corneal recurrence).

Table 1.

Characteristics of patients

	AMT + MMC group	AMT group	p-value*
No. of eyes (patients)	22 (22)	18 (17)
Age (years)	57.6 ± 12.2	57.3 ± 8.4	0.989
Gender (male:female)	11:11	7:10	0.563
Follow-up (months)	21.9 ± 11.9	23.4 ± 13.8	0.717

Values are presented as mean ± SD unless otherwise indicated.

AMT = amniotic membrane transplantation; MMC = mitomycin C.

^* Mann-Whitney U test.

Table 2.

Comparison of recurrence rates according to the surgical method

	AMT + MMC group (22 eyes)	AMT groups (18 eyes)	p-value*
Grade 0^†	6 (27.3)	5 (27.8)	0.989
Grade 1^‡	10 (45.5)	6 (33.3)	0.381
Grade 2^§	4 (18.2)	4 (22.2)	0.840
Grade 3^Π	2 (9.1)	3 (16.7)	0.527
Total (Grade 2 + Grade 3) recurrence rates	6 (27.3)	7 (38.9)	0.545

Values are presented as n (%) unless otherwise indicated.

AMT = amniotic membrane transplantation; MMC = mitomycin C.

^* Mann-Whitney U test;

^† No recurrence;

^‡ Episcleral vessels without fibrovascular tissue;

^§ Conjunctival recurrence;

^Π Corneal recurrence.

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