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Pterygium excision with MMC may decrease endothelial cell count
Am J Ophthalmol. 2011;151(3):488-493.
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Pterygium excision with intraoperative mitomycin C may spur central endothelial cell loss, a study found.
"Because proximity of the application site to the cornea may have an effect on the corneal endothelial cell loss resulting from MMC, we postulated that application of MMC under the conjunctiva away from the limbus, rather than on the perilimbal sclera, may result in less endothelial cell loss," the study authors said.
The prospective, randomized study included 56 eyes of 56 patients who underwent pterygium excision, removal of subconjunctival fibrovascular tissue, application of 0.02% MMC and amniotic membrane transplantation. Mean patient age was 41.8 years.
MMC was applied to the perilimbal bare sclera in 28 patients and under the conjunctiva, away from the limbus, in 28 patients. Endothelial cell count was measured preoperatively and at 1 week and 1, 3 and 6 months postoperatively.
Mean preoperative endothelial cell count was 2,810 ± 278 cells/mm² in the scleral MMC group and 2,857 ± 332 cells/mm² in the subconjunctival MMC group.
Mean endothelial cell count in the scleral group was 2,541 ± 296 cells/mm² at 1 week, 2,627 ± 272 cells/mm² at 1 month, 2,699 ± 281 cells/mm² at 3 months and 2,715 ± 290 cells/mm² at 6 months.
Mean endothelial cell count in the subconjunctival group was 2,597 ± 288 cells/mm² at 1 week, 2,665 ± 270 cells/mm² at 1 month, 2,708 ± 286 cells/mm² at 3 months, and 2,713 ± 297 cells/mm² at 6 months.
Differences between preoperative and postoperative endothelial cell counts were statistically significant at all follow-up intervals (both P < .0001).