Evaluation of The Effectiveness of Rotational Conjunctival Flap Compared to Bare Sclera with Mitomycin C After Surgical Removal of Primary Pterygium

Akhtar Amin; Ambreen Ahmad; Arshad Iqbal; Sher Akbar Khan

doi:10.70749/ijbr.v3i5.1280

Authors

Akhtar Amin Saidu Teaching Hospital, Swat, KP, Pakistan.
Ambreen Ahmad Saidu Teaching Hospital, Swat, KP, Pakistan.
Arshad Iqbal Saidu Teaching Hospital, Swat, KP, Pakistan.
Sher Akbar Khan Saidu Teaching Hospital, Swat, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i5.1280

Keywords:

Primary Pterygium, Rotational Conjunctival Flap, Mitomycin C, Recurrence

Abstract

Background: Primary pterygium is a common ocular condition requiring effective surgical management to minimize recurrence. While mitomycin C is frequently used as an adjunct in pterygium surgery, rotational conjunctival flap offers an anatomical restoration approach. Their comparative efficacy remains a subject of investigation. Objective: To compare the efficacy of rotational conjunctival flap and mitomycin C after surgical removal of primary pterygium. Study Design: Randomized controlled trial. Duration and Place of Study: This study was conducted from February 2024 to January 2025 at the Department of Ophthalmology, Saidu Group of Teaching Hospital, Swat. Methodology: A total of 196 patients with primary pterygium, aged 18–60 years, were randomized into two equal groups. Group A underwent rotational conjunctival flap surgery, while Group B received 0.04% MMC application during surgery. Exclusion criteria included systemic diseases, recurrent pterygium, and corneal pathologies. Surgical outcomes were assessed over six months, with efficacy defined as the absence of fibrovascular regrowth ≥1 mm beyond the limbus. Results: Group A demonstrated significantly higher efficacy (90.8%) compared to Group B (76.5%, p=0.007). Stratified analysis revealed superior outcomes for rotational conjunctival flap across various subgroups, including patients >45 years, males, right-eye involvement, and pterygium duration >18 months. Both techniques were well tolerated, with no major complications reported. Conclusion: Rotational conjunctival flap surgery is significantly more effective than mitomycin C in preventing recurrence of primary pterygium.

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