Bağdagül BİLEK, Uğur KEKLİKÇİ, Yıldırım Bayazıt ŞAKALAR, M. Kaan UNLU, İhsan ÇAÇA

Primer pterjium eksizyonunda amnion membran grefti ve intraoperatif mitomisin C yöntemlerinin karşılaştırılması

Primer pterjium tedavisinde insan amnion membranı uygulanmasının etkinlik ve güvenilirliğinin, Mitomisin C uygulanması ile karşılaştırılması amaçlandı. Primer pterjium tanısı konan 60 hastanın 60 gözü çalışmaya dahil edildi. Hastalar rastgele iki gruba ayrılarak, 30 hastanın 30 gözüne, pterjium eksizyonu ile intraoperatif 0.2 mg/ml Mitomisin C uygulandı. Diğer 30 göze ise pterjium eksizyonu ve amnion membranı uygulandı. Amnion membran uygulanan grupta %6.66, Mitomisin C grubunda ise %16.66 nüks gelişti. İki grup nüks açısından karşılaştırıldığında istatiksel olarak anlamlı fark saptanmadı (p > 0.05). Komplikasyon olarak, amnion membran grubunda bir hastada (%3.33) postoperatif erken dönemde sütür açılması saptanırken, Mitomisin C grubunda bir hastada (%3.33) skleral erime, bir hastada da (%3.33) punktat epiteliyopati saptandı. Gruplar komplikasyon yönünden karşılaştırıldıklarında aralarında istatistiksel olarak anlamlı fark bulunmadı (p > 0.05). Her ne kadar iki grup arasında komplikasyon ve nüks açısından istatistiksel olarak anlamlı fark görülmese de; primer pterjium cerrahisinde amnion membran kullanımının intraoperatif Mitomisin C kullanımından daha güvenilir olduğu kanatine varıldı.

Comparison of amniotic membrane grafts and ıntraoperative mitomycin C for primary pterygium excision

To evaluate and compare the effectiveness and safety of the human amniotic membrane graft with intraoperative application of Mitomycin C in primary pterygium surgery. In 60 consecutive patients, 60 eyes were included in the study. The patients were randomly divided into two groups, primary pterygium excision with intraoperative Mitomycin C (0.2 mg/ml) were applied to the 30 patients and amniotic membrane grafts were applied to the other 30 patients. Recurrence was detected in two patients (%6.66) who received amniotic membrane grafts, and in five patients (%16.66) who received primary pterygium excision with intraoperative Mitomycin C. No statistical difference was observed between groups according to the reccurence (p > 0.05). Suture lysis in early postoperative period was detected in one patient (%3.33) who received amniotic membrane grafts. Scleral melting was developed in one patient (%3.33) and punctate epitheliopathy was developed in one patient (%3.33) who received primary pterygium excision with intraoperative Mitomycin C. No statistical difference was observed between groups according to the complications (p > 0.05). Although no statistical difference was observed between two groups according to complication and reccurence, amniotic membrane graft method was safer than primary pterygium excision with intraoperative Mitomycin C.

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