الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The main complication of the management of pterygium is the recurrence• However man modulations of adjunctive treatments with variable success rates Howe y have been developed but, no single treatment has been universally effective.
In the present study comparison between the post-operative results that were obtained by the conjunctival flap, after pterygium excision (large-flap technique) and application of MM-C followed by conjunctival flap, after pterygium excision
i- fla technique) was performed as regards their effect on the recurrence, (Min p surgical time and complications and best corrected visual acuity they caused .
ducted on 30 eyes of 30 cases , The selection of cases was
The study was con
attending the out-patients clinics of Benha university They
don were
e from patients
these
randomly divided into two groups ( 15 eyes in each group ), group s were:
GrouPI He_
in thisgroupwere submitted to (Large-flap technique), excision Cases included g
of the pterygium then performing a large conjunctival transposition flap.
Group
his roup were submitted to (Mini-flap technique), excision of
Cases included in this g
in MM-C 0.02 % and performing a small conjunctival the pterygium, apply g transposition flap.
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Summary ct Conclusion
The post-operative follow-up for all cases ranged from (6 - 6.7) months, the recurrence rate was found to be 10 % where 3 cases recurred among the 30 cases of the study. The recurrence occurred only in group I ( large flap technique) where 3 cases recurred out of 15 cases ( 20 %) .No recurrence occur in group II (Mini-flap technique). The difference between the 2 groups was statistically nt.
The recurrence rate of mini flap technique was zero, however this is not necessarily the result of the surgical technique; it could be the result of the combination of the conjunctival flap with the use of intraoperative MM-C.
There were no significant statistically relation between the recurrence and age, sex or occupation of the patients.
Also, the post-operative complication had occurred in 13.3 % of the cases included in this study. The complications were not serious, the commonest complication was wound dehiscence which represent 6.7% of the complications, conjunctival scar (3.3%) and granuloma (3.3%), the incidence of complications was low in group II (Mini-flap technique) which was (6.7%) where 1 case showed postoperative complication out of (15) cases. But the incidence was higher in group I (large- flap technique) which was (20 %) where (3) cases out of (15) cases showed complications, the incidence of postoperative complications was non significantly.
The Mini flap technique was technically easier and simple than large flap technique where the size of bare sclera in large-flap technique changes according to the pterygium size whiles it constant in mini-flap technique.
Summary &Conclusion
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The mean surgical time was 39.4 minutes in Group I (large flap technique) and 29.7 minutes in Group H (Mini flap technique). So, the operating time was significantly shorter with the mini-flap technique than with large-flap technique.
The bets corrected visual acuity was unchanged in 11 cases (7 cases in large flap technique group and 4 cases in Mini flap technique group) and improved in 19 cases (8 cases in large technique group and 11 cases in Mini flap technique group). There was no statistically significant difference between the tow groups as regard
unchanged and changed best corrected visual acuity.
Summaty &Conclusion
Conclusion
from this study we can conclude that ;
■ The pterygium should be properly excised under microscope to avoid complications.
■ Don’t use bare-sclera excision alone and use one of these adjunctive
methods which were more or less safe, and effective in reducing the recurrence .
■ Covering the bare sclera with conjunctival flap having its blood
supply, the use of the lowest effective dose of MM-C, and avoid
excessive cauterization make MM-C a safe drug with less complications .
■Both large flap and mini flap techniques are safe and effective in reducing the recurrence of pterygium.
■There was no significant relation between the recurrence and age, sex or occupation of the patient.
■The Mini flap technique is technically easier, less operating time , and
induced fewer post operative complications and considered useful for preventing pterygium recurrence.
•The mini-flap technique is one of the most effective methods and is agood alternative to large flap technique for preventing the recurrence.