97th DOG Annual Meeting 1999
LONG TERM RESULTS AFTER BARE SCLERA PTERYGIUM RESECTION WITH EXCIMER SMOOTHING AND LOCAL APPLICATION OF MITOMYCIN C
T. Walkow, N. Anders
Background: In the present study long term results and complications of the combined local application of mitomycin C and smoothing of the wound area with an excimer laser after bare sclera resection should be investigated prospectively.
Patients and Methods: 133 eyes of 91 patients underwent pterygium surgery using the bare sclera technique. 29 of them were from North- or Central Europe, 65 came from Southern Europe and 7 from Africa or Asia. Thirty-one of these treated eyes (23%) were recurrences with a median of two previous operations (range 1-6). Afterwards phototherapeutic keratectomy with an ArF:excimerlaser was performed in the area of the excision. Additionally all patients were treated with mitomycin C 0.02% twice daily for four days and for four weeks with a combination of gentamicin and dexametason eye drops triple a day. Minimum follow-up was 36 month (median 53 month).
Results: In the group with primary pterygias occurred three recurrences (2.9%) after 6, 12 and 28 months. In the group with previous operations two recurrences (6.4%) were recorded. Uncorrected visual acuity improved from 0.61 preoperatively to 0.79 postoperatively (P<0.0001), best corrected visual acuity went from 0.82 to 0.91 (P=0.0001) [LogMAR]. Mean astigmatism was significantly reduced from 1.54 D preoperatively to 0.61 D postoperatively (P<0.0001). In seven eyes discrete granulomas developed postoperatively, in three cases a dellen formation, which persisted for a maximum of 4 month, occurred. No further complications were recorded during the follow-up.
Conclusion: Pterygium excision using the bare-sclera technique, phototherapeutic keratectomy and local application of mitomycin C 0.02% eye drops is a safe method with a low recurrence rate.
Department of Ophthalmology, Humboldt-University of Berlin, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin