Outcomes of pterygium surgery with anti-fibrotics

Abstract

Aim: To compare the outcomes of pterygium surgery performed with adjunctive bevacizumab and mitomycin C.  Methodology: Design: Prospective cohort study. Outcome measures: Post-operative complications; post-operative visual acuity
Consecutive adult patients with pterygium seen at St Joseph Eye Hospital Mgbirichi in August-October 2019 were recruited into the study. At surgery they were randomized to receive either topical mitomycin C (0.02%) or sub-conjunctival bevacizumab (2.5mg/0.1ml) during surgery. One surgeon performed all the surgeries using bare sclera technique. Each patient was followed-up for 6 months for evidence of complications; pre- and post-operative visual acuities were also evaluated. Study was approved by Nnamdi Azikiwe University Teaching Hospital Research Ethics Committee. Results: Ninety patients comprising 39(43.3%) males and 51(56.7%) females with mean age - 55±4.0 years, range - 30-70 years, were studied. Complications at 6 months’ post-surgery were persistent redness, 17 (18.9%); recurrence, 13(14.4%), granuloma, 2(2.2%). The recurrence rate significantly was less for mitomycin C, 2(4.4%), compared to bevacizumab, 11(24.4%) [Risk Ratio - 6.0; p<0.001]. Visual impairment reduced from 41.1% pre-operatively to 3.3% post-operatively (Risk Ratio – 2.5; p<0.05). Conclusion: Study demonstrated good outcomes both in terms of minimal post-operative complications and improved post-surgery acuity. But mitomycin C is more effective in preventing recurrence.