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Postoperative instillation of 0.04% mitomycin C in the treatment of primary pterygium in Zaire.

PURPOSE
to investigate, in the first report in Central Africa, the influence of tropical Mitomycin C on the recurrence rate and on the complications after surgical treatment for primary pterygium.


METHODS
Sixty-six patients with primary pterygia underwent excision of the lesion, leaving the sclera bare. Patients were randomized in two groups: in one group (36 eyes in 33 patients) 0.04% mitomycin C eye drops were used four times daily during two weeks or longer after surgery, the other group (41 eyes in 33 patients) underwent only surgery. The mean follow-up period was 6 months (range, one to 24 months).


RESULTS
seven (19.4%) pterygia recurred in the group of eyes treated with topical 0.04% mitomycin C and 11 (26.8%) in the group of eyes treated without this drug. This difference was not significant (p > 0.05). Complications were observed in two (5.6%) eyes in group 1 and included conjunctival granuloma (one eye) and transient ocular hypertension. In group 2, complications were noted in four eyes (9.8%) and included conjunctival granulomas (three eyes) and symblepharon (one eye). Ocular hypertension could be due to instillation of mitomycin C. No group had significantly more complications.


CONCLUSION
primary excision of pterygium with postoperative instillation of 0.04% mitomycin C had a higher rate of occurrence in this study than previously reported in Japan, in the USA and Europe.