5-Fluorouracil in primary, impending recurrent and recurrent pterygium: Systematic review of the efficacy and safety of a surgical adjuvant and intralesional antimetabolite

Lee, Brendon W.H.; Sidhu, Amitouj S.; Francis, Ian C.; Coroneo, Minas T.

doi:10.1016/j.jtos.2022.08.002

Cited by 13 publications

(9 citation statements)

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“…Amoxicillin is a bactericidal β-lactam antibiotic drug molecule from the aminopenicillin family, which can be used to treat various diseases caused by bacterial infections and prevent bacterial growth [ 36 , 37 ]. 5-Fluorouracil (5-FU) is an antimetabolite antitumor drug used to treat various solid tumors, such as colorectal, rectal, breast, gastric, pancreatic, liver, and bladder cancer [ 19 , 38 ]. Figure 9 a shows the SERS spectra of different concentrations of amoxicillin solution on CuO@RF@Ag nanowires (0.45 mM).…”

Section: Resultsmentioning

confidence: 99%

Ag Nanoparticles Decorated CuO@RF Core-Shell Nanowires for High-Performance Surface-Enhanced Raman Spectroscopy Application

Chang

et al. 2022

Molecules

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Vertical-aligned CuO nanowires have been directly fabricated on Cu foil through a facile thermal oxidation process by a hotplate at 550 °C for 6 h under ambient conditions. The intermediate layer of resorcinol–formaldehyde (RF) and silver (Ag) nanoparticles can be sequentially deposited on Cu nanowires to form CuO@RF@Ag core-shell nanowires by a two-step wet chemical approach. The appropriate resorcinol weight and silver nitrate concentration can be favorable to grow the CuO@RF@Ag nanowires with higher surface-enhanced Raman scattering (SERS) enhancement for detecting rhodamine 6G (R6G) molecules. Compared with CuO@Ag nanowires grown by ion sputtering, CuO@RF@Ag nanowires exhibited a higher SERS enhancement factor of 5.33 × 108 and a lower detection limit (10−12 M) for detecting R6G molecules. This result is ascribed to the CuO@RF@Ag nanowires with higher-density hot spots and surface-active sites for enhanced high SERS enhancement, good reproducibility, and uniformity. Furthermore, the CuO@RF@Ag nanowires can also reveal a high-sensitivity SERS-active substrate for detecting amoxicillin (10−10 M) and 5-fluorouracil (10−7 M). CuO@RF@Ag nanowires exhibit a simple fabrication process, high SERS sensitivity, high reproducibility, high uniformity, and low detection limit, which are helpful for the practical application of SERS in different fields.

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Section: Resultsmentioning

confidence: 99%

Ag Nanoparticles Decorated CuO@RF Core-Shell Nanowires for High-Performance Surface-Enhanced Raman Spectroscopy Application

Chang

et al. 2022

Molecules

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“…[42][43][44] Some of these complications may be attributable to adjuvant antimetabolite use (mitomycin C) or steroid injections, 42,44 with the former known to be associated with sight-threatening complications. 28,45 Systematic reviews have also concluded that a conjunctival autograft is associated with a 50% lower recurrence rate at 6 months postoperatively than amniotic membrane transplantation, particularly in recurrent pterygia. 46,47 Logistic regression models determined that the only factor significantly correlated to pterygium recurrence was age.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of a consensus on pterygium recurrence definitions results in inconsistent reporting of recurrence rates from clinical studies and remains an obstacle to determining the optimal technique. 28 Most pterygium descriptions are based on macroscopic analysis through slit-lamp biomicroscopy and photography. The authors have also identified preclinical evidence of corneal invasion through the identification of Fuchs flecks on in vivo confocal microscopy, which may indicate impending clinical invasion.…”

Section: Discussionmentioning

confidence: 99%

“…19,20 Reconstructive techniques, such as pterygium extended removal followed by extended conjunctival transplant (PERFECT), [21][22][23] limbal-conjunctival or conjunctival autograft, 4,[24][25][26][27] and amniotic membrane transplant, have demonstrated superior efficacy and very low pterygium recurrence rates compared with historical modalities. 28 The development of wet-lab teaching models and femtosecond laser-assisted conjunctival flaps may also increase surgical efficiency and reduce the impact of surgical skill on pterygium recurrence. 29,30 In this report, the authors present a modified limbal-conjunctival autograft technique for primary and recurrent pterygia that offers a very low recurrence rate and minimal complications, without being too technically complex and time-consuming.…”

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confidence: 99%

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Modified Limbal–Conjunctival Autograft Surgical Technique: Long-Term Results of Recurrence and Complications

Lee

Tat³

et al. 2023

Cornea

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Purpose: The aim of this study was to report the recurrence and complication rates of a modified limbal–conjunctival autograft surgical technique for pterygium excision. Methods: This was a retrospective, single-surgeon, single-operating environment, consecutive case series of 176 eyes in 163 patients with a biopsy-proven diagnosis of pterygium. All patients underwent excision using a 23-gauge needle to “behead” the pterygium head, followed by a limbal–conjunctival autograft including ∼50% of the palisades of Vogt. Outcomes measured included recurrence, defined as any conjunctival fibrovascular growth, and complication rates. Correlations between preoperative patient characteristics, pterygium morphology, and intraoperative factors (width of corneal extension, conjunctival defect, and graft) with postoperative recurrence were examined using logistic regression models. Results: The median age was 59.5 years and 122 eyes (69.3%) had primary pterygium (type I: 17%, II: 37.5%, and III: 45.5%). Kaplan–Meier analysis demonstrated the median pterygium-free follow-up period to be 723 days (range 46–7230 days). Recurrence was observed in 3 eyes of 2 patients (1.7%). No postoperative graft-related complications were observed. Postoperative symptomatology was transient. Age demonstrated a negative correlation with recurrence (odds ratio 0.888, 95% CI, 0.789–0.998, P = 0.046). However, no other correlations with preoperative or intraoperative factors, including whether pterygium was primary or recurrent, were identified (all P > 0.05). Conclusions: This modified limbal–conjunctival autograft technique represents an effective alternative that offers a very low recurrence rate and avoids extensive dissection or antimetabolites, with minimal complications and transient postoperative symptomatology, over a long-term follow-up period. This technique is relatively simple and successful for both primary and recurrent pterygia. Future comparative studies with other surgical techniques may determine which are superior.

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“…However, the main concern about the surgery is the high level of recurrence, with about 1.9–8% in conjunctival autograft ( 3 ), 38–88% in bare sclera, ( 4 ) and 0–17% in limbal conjunctival autograft ( 5 ). Therefore, many adjuvant treatments, including 5-FU ( 6 ), mitomycin C ( 7 ), and ciclosporin A ( 8 , 9 ), have been developed trying to diminish recurrence.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

Zhang,

Dong,

Sun

2023

Front. Med.

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PurposeTo further evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) agents in management of primary pterygium.MethodsRandomized controlled trials (RCTs) in databases of PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to September 2022. Recurrences and complications were evaluated as the pooled risk ratio (RR) and 95% confidence interval (CI) using random-effects model.ResultsIn total of 1,096 eyes in 19 RCTs were included. Anti-VEGF agents statistically decreased recurrence rate of pterygium following surgery (RR 0.47, 95% CI 0.31–0.74, P < 0.001). Subgroup analysis showed that anti-VEGF as an adjunct to bare sclera (RR 0.34, 95% CI 0.13–0.90, P = 0.03) and conjunctival autograft (RR 0.50, 95% CI 0.26–0.96, P = 0.04) statistically reduced recurrence rate, while the effect was not favorable for conjunctivo-limbo autograft (RR 0.99, 95% CI 0.36–2.68, P = 0.98). Anti-VEGF agents statistically decreased recurrence in White patients (RR 0.48, 95% CI 0.28–0.83, P = 0.008), while didn't in Yellow patients (RR 0.43, 95% CI 0.12–1.47, P = 0.18). Both topical (RR 0.19, 95% CI 0.08–0.45, P < 0.001) and subconjunctival anti-VEGF agents (RR 0.64, 95% CI 0.45–0.91, P = 0.01) had a positive influence on recurrence. There was no statistically significant difference in complications between the groups (RR 0.80, 95% CI 0.52–1.22, P = 0.29).ConclusionsAs adjuvant treatment, anti-VEGF agents statistically reduced the recurrence following pterygium surgery, especially among White patients. Anti-VEGF agents were well tolerated without increased complications.

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5-Fluorouracil in primary, impending recurrent and recurrent pterygium: Systematic review of the efficacy and safety of a surgical adjuvant and intralesional antimetabolite

Cited by 13 publications

References 120 publications

Ag Nanoparticles Decorated CuO@RF Core-Shell Nanowires for High-Performance Surface-Enhanced Raman Spectroscopy Application

Ag Nanoparticles Decorated CuO@RF Core-Shell Nanowires for High-Performance Surface-Enhanced Raman Spectroscopy Application

Modified Limbal–Conjunctival Autograft Surgical Technique: Long-Term Results of Recurrence and Complications

Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

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