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Abstract

Background: Pterygium is a common ocular surface disorder characterized by a fibrovascular growth of conjunctival tissue onto the cornea. Surgical excision is the primary treatment, but recurrence remains a significant challenge. This study compares the efficacy and safety of conjunctival limbal autograft (CLAG) and intraoperative topical Mitomycin C (MMC) in preventing recurrence after primary pterygium surgery.
Methods: A hospital-based randomized controlled trial was conducted at the Department of Ophthalmology, IIMS&R, Lucknow, involving 70 patients with primary pterygium. Participants were randomly assigned to Group A (MMC, n=35) or Group B (CLAG, n=35). Preoperative and postoperative assessments included visual acuity, tear film tests (TBUT and Schirmer's), slit lamp examination, and recurrence grading using Prabhasawat's classification. Patients were followed for 6 months.
Results: Recurrence was observed in 8.5% of Group A and 2.8% of Group B at 6 months. The mean time to recurrence was slightly earlier in the MMC group (175.14 ± 5.26 days) compared to the CLAG group (178.43 ± 2.12 days). Postoperative complications like corneal haze were more common in the MMC group. Visual acuity improved in both groups, but CLAG had better postoperative stability and fewer complications.
Conclusion: Both CLAG and MMC are effective in reducing pterygium recurrence, but CLAG is superior in terms of lower recurrence and complication rates. It is recommended as the preferred surgical approach in primary pterygium cases.