الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pterygium is a common keratoconjuctival degenerative lesion in tropical and subtropical regions. Egypt is considered one of the areas in which pterygium is present.The exact aetiology of the pterygium is not known but many theories have proposed to explain the aetiology of the pterygium. The role of ultraviolet light in the pathogenesis of pterygium is the most accepted theory because of the prevalence of the pterygium in the tropical areas. It occurs more among people who work outdoors rather than indoors.the pterygium appears as a triangular fleshy growth encroaching onto the cornea called the head, the body present over the sclera, the neck is that part lying on the limbus behined the head. A pterygium does not give rise to symptoms if it is small. It may affect the vision if it progresses onto the pupillary area of the cornea or causes diplopia if it is large due to limitation of abduction from traction on the conjunctiva.Medical management is used to control symptoms and minimize factors believed to promote prognosis. The main complication of the surgical removal of pterygium is the recurrence. So many workers have tried different techniques to minimize the incidence of recurrence.These techniques include, pterygium excision with bare area which is the simplest and widely method used, however, it is by far the least satisfactory method with respect to recurrence rate, which may be as high as 80%.Pterygium excision and conjunctival autograft (free–sliding– rotation–limbal) was believed to prevent the edge of an excised pterygium from spreading over the cornea by contact inhibition. The 81-Summary recurrence rates of pterygium after excision with conjunctival graft ranged are about 6%-21%.Pterygium excision followed by application of B-irradiation decreases the rate of recurrence of pterygium to about 17%. Pterygium excision followed by application of mitomycin-C which is antineoplastic/antibiotic alkylating agent inhibit the DNA replication and lead to cell death has been reported with a recurrence rate ranges from 4%-11%. In the present study, the safety and efficacy of subconjunctival mitomycin-C one month before bare sclerd excision of primary pterygium has been studied.This study was conducted on 24 eyes of 24 cases with primary pterygia. The selection of cases was done from patient attending the outpatients clinic of Minoufiya University Hospital during the period from March 2004 to April 2005. All cases were submitted to subconjunctival injection of 0.1 ml of 0.15 mg/ml of mitomycin-C at the pterygium one month before pterygium excision with bare sclera technique. The cases were followed up for 8-12 months, with a mean of 9.67 months. The recurrence rate was found to be 4.2% where one case recurred after 6 months postoperatively. Subconjunctival mitomycin-C injection needs less operative time and is technically easy with no serious complications.Preoperative adjunctive therapy of subconjunctival mitomycin-C followed by bare sclera excision is a safe and effective treatment modality for the management of pterygium.