https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/152 Sun, 11 Dec 2016 17:10:42 +0000 Abstract Background and objectives: Recurrent pterygium is an important ocular problem in our country.  There are different modalities of treatment for recurrent pterygium. The present study was undertaken to determine the effect of intraoperative mitomycin C along with conjunctival auto graft to prevent recurrence of pterygium. Study population Group 1 Number (%) Group 2 Number (%) Total patients 27 27 Male 21 (77.8) 19 (70.4) Female   6 (22.2)   8 (29.6) Recurrence of pterygium after 1 year 21 (77.7)   0   Group 1= Conjunctival auto graft only; Group 2= Conjunctival auto graft plus intraoperative mitomycin C.   Discussion Pterygium surgery has changed over the past decade, and several techniques are now available. Our study presents the efficacy of   intraoperative use of mitomycin C along with conjunctival auto grafting to reduce the recurrence of pterygium with minimal postoperative complications. In pterygium surgery, daily administration or single intraoperative use of a variety of mitomycin C doses have been reported [5-8, 10-12, 22, 23]. However, the safest dosage of mitomycin C that can prevent the recurrence of pterygium without causing complications is still unknown. Postoperative use of topical mitomycin C is not recommended because of a possible drug misuse, which may cause severe ocular complications such as scleromalacia, corneal perforation, glaucoma, iritis, pain, and punctate keratopathy [6–9]. Single intraoperative use of mitomycin C has been found safer than postoperative topical daily application [10–12, 24]. The recurrence rate of primary and recurrent pterygia treated with mitomycin C was approximately 6.7-22.5% over different period of time, and only mild complications such as superficial punctate keratopathy and mild avascularity of the bare sclera area were observed [25, 26]. A study has recently demonstrated normal sclera thickness and conjunctival epithelial phenotype at the surgical site more than six years after pterygium surgery with mitomycin C [27]. When bare sclera technique is performed in a patient with normal ocular surface, the epithelialization of the wound area is usually completed within 7 to 14 days [10, 11]. Intact epithelium over the operated area is necessary to prevent scleral melting after pterygium surgery when mitomycin C is used. To prevent scleral melting, we kept the conjunctiva overlying the body of the pterygium and sutured it back to the sclera at the end of the procedure. To avoid severe ocular complications, patients with abnormal ocular surface who were at greater risk for a delay of epithelialization or excessive inflammation, such as patients with immune disorders, blepharitis or dry eyes, were excluded from our studies. Furthermore, postoperatively, we closely observed the patients until the epithelialization of the ocular surface was complete. In the present study, we found that conjunctival auto graft with single application of intraoperative mitomycin C had no post operative recurrence after 12 months of surgery while the  recurrence rate was 77.7% among the patients where only grafting was performed without mitomycin C. Therefore, conjunctival auto grafting combined with intraoperative application of 0.02% mitomycin C for one minute was more effective than conjunctival auto grafting alone. 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