Long-term results after bare sclera pterygium resection with excimer smoothing and local application of mitomycin C.

Purpose: To evaluate the long-term results and complications after bare sclera pterygium excision with local application of mitomycin C and consecutive smoothing of the wound area with an excimer laser (PTK).

Methods: This was an observational case series of 133 eyes of 101 patients who underwent pterygium surgery using the bare sclera technique. Thirty-one of these treated eyes (23%) were recurrences with a mean of 3 previous operations. After pterygium surgery, phototherapeutic keratectomy with an ArF:excimer laser was performed in the area of the excision. Additionally, all patients were treated with mitomycin C 0.02% twice daily for 4 days. Median follow-up was 53 months (minimum, 36).

Results: In the group with primary pterygia, 3 recurrences occurred after 6, 12, and 28 months (recurrence rate, 2.9%). In the group with previous pterygium operations, 2 recurrences (recurrence rate, 6.4%) were recorded. Uncorrected visual acuity of all treated patients improved from 0.61 preoperatively to 0.79 postoperatively (P < 0.0001), best corrected visual acuity increased from 0.82 to 0.91 (P = 0.0001) [LogMAR]. Mean astigmatism was significantly reduced from 1.54 D preoperatively to 0.61 D postoperatively (P < 0.0001). In 7 eyes, discrete granulomas developed postoperatively (5.3%); in 3 cases (2.3%), dellen formation occurred that persisted for a maximum of 4 months. No further complications were recorded during the follow-up.

Conclusions: Pterygium excision using the bare sclera technique, phototherapeutic keratectomy, and local application of mitomycin C 0.02% eyedrops is a safe method with good functional results and a low recurrence rate.