Intraoperative mitomycin in primary pterygium excision - A prospective, randomized trial
Intraoperative mitomycin in primary pterygium excision - A prospective, randomized trial
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DOI：
10.1016/s0161-6420(97)30224-3
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发表时间：
1997-05-01
期刊：
影响因子：
13.7
通讯作者：
Yee, RW
中科院分区：
文献类型：
--
作者：
Manning, CA;Kloess, PM;Yee, RW
目的：自体结膜移植和术后丝裂霉素治疗是两种辅助治疗方法，可降低单纯切除翼状胬肉的高复发率。作者进行了一项前瞻性、随机研究，将这两种技术与术中应用丝裂霉素的相对较新的治疗方法进行比较。方法：50 名患有 56 处原发性翼状胬肉的患者被随机分为 3 个治疗组中的 1 个：自体结膜移植（第 1 组）、术后丝裂霉素 0.2 mg/ml 每天四次 x 7 天（第 2 组）和术中丝裂霉素 0.4 mg/ml x 3 分钟（第 2 组） 3）。平均随访时间为 16 个月（范围为 6 至 28 个月）。结果：第 1 组 18 只眼中的 4 只眼（22.2%）出现复发，第 2 组 19 只眼中有 4 只眼（21.1%）出现复发，第 3 组 19 只眼中有 2 只眼（10.5%）出现复发。第 2 组中的 2 名患者出现并发症，通过巩膜补片移植成功地控制了巩膜变薄，上皮毒性在术后第 6 天停止丝裂霉素后得到解决。其他两组没有出现并发症。结论：术中丝裂霉素是术后丝裂霉素治疗的一种简单有效的替代方案，在研究期间显示出其系列中复发率最低且无毒性。如果决定使用辅助丝裂霉素，作者建议术中应用而不是术后给药。
Purpose: Conjunctival autograft transplantation and postoperative mitomycin therapy are two adjuvant treatment methods shown to lessen the high pterygium recurrence rate seen with simple excision alone. The authors conducted a prospective, randomized study comparing these two techniques with a relatively new treatment method using intraoperative mitomycin application.Methods: Fifty patients with 56 primary pterygia were randomized to 1 of 3 treatment groups: conjunctival autograft (group 1), postoperative mitomycin 0.2 mg/ml four times a day x 7 days (group 2), and intraoperative mitomycin 0.4 mg/ml x 3 minutes (group 3). The mean follow-up time was 16 months (range, 6 to 28 months).Results: Recurrences developed in 4 (22.2%) of 18 eyes in group 1, 4 (21.1%) of 19 eyes in group 2, and 2 (10.5%) of 19 eyes in group 3. Complications developed in two patients from group 2, scleral thinning managed successfully with a scleral patch graft, and epithelial toxicity that resolved on discontinuation of mitomycin on postoperative day 6. There were no complications in the other two groups,Conclusions: Intraoperative mitomycin is a simple and effective alternative to postoperative mitomycin therapy, showing the lowest recurrence rate in their series with no toxicity during the study period. If the decision is made to use adjunctive mitomycin, the authors recommend intraoperative application over postoperative administration.