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To evaluate the safety and efficacy of a preoperative injection of mitomycin C (MMC) in combined pterygium and cataract surgery.This was a prospective, nonrandomized, interventional trial. Thirty-nine patients with cataract and pterygium enrolled in a prospective, nonrandomized trial. All patients underwent combined pterygium and cataract surgery. Twenty-seven received a single 0.1-mL injection of 0.15 mg/mL MMC into the pterygium head 4 weeks before surgery and 12 did not. Patients were followed for 12 to 23 months postoperatively. Recurrence of pterygium, side effects, and complications of MMC were recorded.Recurrent pterygium developed in none of the patients treated with MMC preoperatively and in 5 of the nontreated patients. Two patients in the pretreated group had allergic conjunctivitis immediately after MMC injection. No other local eye complications or adverse systemic reactions were recorded.Preoperative injection of MMC into the head of the pterygium 4 weeks prior to combined pterygium and cataract surgery resulted in no recurrence and no serious complications up to 12 to 23 months of follow-up postoperatively. This procedure may be recommended to save time and cost and to prevent the possible side effects of MMC when administered topically at the time of cataract surgery. Further follow-up and additional studies will be needed to determine the long-term safety and efficacy.