Lam D S, Wong A K, Fan D S, Chew S, Kwok P S, Tso M O
Prince of Wales Hospital, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin.
Ophthalmology. 1998 May;105(5):901-4; discussion 904-5. doi: 10.1016/S0161-6420(98)95034-5.
The purpose of the study was to examine the efficacy of intraoperative mitomycin C (MMC) in preventing recurrence of pterygium after excision and the postoperative complications encountered.
The study design was a prospective, randomized, clinical trial.
A total of 180 primary and recurrent pterygia were recruited for the study. They were randomized into five groups: A, control with no MMC; B, 0.02% MMC for 5 minutes; C, 0.04% MMC for 5 minutes; D, 0.02% MMC for 3 minutes; and E, 0.04% MMC for 3 minutes.
All patients received pterygium excision with or without the above four modes of intraoperative MMC application.
Recurrence of pterygium and postoperative complications such as superficial scleral melting were measured.
At a mean follow-up of 30 (groups A-C) and 20 months (groups D and E), the respective recurrence rates in groups A through E were 75%, 8.3%, 8.6%, 42.9%, and 22.9%. There were two cases of postoperative superficial scleral melting in group C. Otherwise, no major postoperative complications were encountered.
The midterm results of a single intraoperative application of MMC at the concentration of 0.02% for 5 minutes are encouraging. Its application as an adjunctive therapy for the surgical treatment of pterygium appeared to be safe and effective. However, because of the possibility of serious late complications, the authors suggest that this procedure be reserved for patients who have high probability of recurrence after excision of pterygium.
本研究旨在探讨术中使用丝裂霉素C（MMC）预防翼状胬肉切除术后复发的疗效以及所遇到的术后并发症。
本研究设计为一项前瞻性、随机临床试验。
共有180例原发性和复发性翼状胬肉纳入本研究。他们被随机分为五组：A组，不使用MMC作为对照；B组，0.02%MMC处理5分钟；C组，0.04%MMC处理5分钟；D组，0.02%MMC处理3分钟；E组，0.04%MMC处理3分钟。
所有患者均接受翼状胬肉切除术，术中应用或不应用上述四种MMC处理方式。
测量翼状胬肉的复发情况以及术后并发症，如浅层巩膜融解。
平均随访30个月（A - C组）和20个月（D组和E组）时，A组至E组各自的复发率分别为75%、8.3%、8.6%、42.9%和22.9%。C组有2例术后浅层巩膜融解。除此之外，未遇到重大术后并发症。
术中单次应用浓度为0.02%的MMC持续5分钟的中期结果令人鼓舞。其作为翼状胬肉手术治疗的辅助疗法似乎安全有效。然而，由于存在严重晚期并发症的可能性，作者建议该方法仅适用于翼状胬肉切除术后复发可能性高的患者。
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