Panda A, Das G K, Tuli S W, Kumar A
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Am J Ophthalmol. 1998 Jan;125(1):59-63. doi: 10.1016/s0002-9394(99)80235-9.
To report the efficacy and safety of intraoperative application of mitomycin C in surgery for pterygium.
In a prospective randomized and double-blind study done within a span of 2.5 years in 50 eyes (50 patients) with primary progressive pterygium, mitomycin C in a concentration of 0.02 mg/ml soaked in a sterile 5 x 5-mm sponge was applied over the bare sclera intraoperatively as an adjuvant therapy in 25 eyes after pterygium excision. These cases were compared with another 25 similar eyes that underwent the same procedure but in which gentamicin solution 0.3% was used instead of mitomycin C solution.
Three eyes (12%) in the mitomycin C group showed recurrence within 7 months of surgery compared with eight eyes (32%) of the gentamicin control group within 3 to 5 months. Mild side effects, such as pain, photophobia, and delayed wound healing, were observed within the first 1 to 2 weeks postoperative in both groups. In the mitomycin C-treated group, corneal changes in the form of superficial punctate keratitis (three eyes) and limbal avascularity (two eyes) subsided within 2 weeks postoperatively. Follow-up time for these cases ranged from 18 to 21 months.
A diluted solution of mitomycin C, 0.02 mg/ml, with an accurate size of sterile sponge applied to bare sclera after primary pterygium excision decreases the rate of recurrence to a greater extent than does gentamicin solution and is not associated with severe complications.
报告术中应用丝裂霉素C治疗翼状胬肉的疗效和安全性。
在一项为期2.5年的前瞻性随机双盲研究中，对50例（50只眼）原发性进行性翼状胬肉患者，25只眼在翼状胬肉切除术后，术中在裸露的巩膜上应用浓度为0.02mg/ml的丝裂霉素C浸泡于无菌5×5mm海绵中作为辅助治疗。将这些病例与另外25只相似的眼睛进行比较，这25只眼接受相同手术，但使用0.3%庆大霉素溶液代替丝裂霉素C溶液。
丝裂霉素C组有3只眼（12%）在术后7个月内复发，而庆大霉素对照组有8只眼（32%）在术后3至5个月内复发。两组在术后1至2周内均观察到轻度副作用，如疼痛、畏光和伤口愈合延迟。在丝裂霉素C治疗组中，浅表点状角膜炎（3只眼）和角膜缘无血管（2只眼）形式的角膜变化在术后2周内消退。这些病例的随访时间为18至21个月。
原发性翼状胬肉切除术后，应用0.02mg/ml的丝裂霉素C稀释溶液并将精确尺寸的无菌海绵应用于裸露的巩膜，其复发率比庆大霉素溶液降低的程度更大，且不伴有严重并发症。
