Conjunctival Autograft Versus Non-bare Sclera Mitomycin C in Surgery of Primary Pterygium

Objective: To evaluate and compare the efficacy of using conjunctival autograft and non-bare sclera mitomycin C (MMC) techniques as two treatment options for primary pterygium. Patients and Methods: Retrospective comparative study included 55 eyes in 55 patients with primary pterygium. 30 eyes of 30 patients (group 1) underwent pterygium excision followed by conjunctival autograft. 25 eyes of 25 patients (group 2) underwent pterygium removal followed by intraoperative application of 0.02% MMC for 2 minutes with conjunctival preservation (non-bare sclera technique). Both groups were compared in terms of surgery time, pterygium size, cosmetic effect, pterygium recurrence and complications. Results: Mean pterygium size was (3.1 ± 0.64 mm and 2.6 ± 0.94 mm) in group 1 and 2, respectively (p =0.1). Mean surgery time was significantly shorter in MMC group (26.4 ± 6.39 min) as compared  to conjunctival autograft group (47.9 ± 11.7 min) (P < 0.0001).  Pterygium recurrence was not seen in any of the patients. Mean follow up time was (14.8 ± 6 and 17.2 ± 9.6 months) in group 1 and 2, respectively (p = 0.4). Conclusion: Both conjunctival graft and non-bare sclera MMC techniques are comparable as regard of pterygium recurrence. MMC technique has significantly shorter surgery time, better cosmoses and lower incidence of complications. Preserving the conjunctiva should be considered when the patient has a history of glaucoma or there is insufficient conjunctiva.