Postoperative subconjunctival 5-fluorouracil in the management of recurring pterygium

Pherwani, Anupama; Vakil, Vipul; Eatamadi, Habibullah; Singh, Ravinder Pal; Dua, Harminder S.

doi:10.1136/bjo.2006.101956

Cited by 17 publications

(8 citation statements)

References 11 publications

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“…Images from our previously published case, both before and after injections, were used as reference pictures to determine the beneficial effect of the injections. 19 The arrest of progression was considered when no further advance of the lesion was noted over three follow-up visits, 1-2 weeks apart.…”

Section: Methodsmentioning

confidence: 99%

“…In 2007, we reported a single case of multiple post-surgical recurrences of pterygium in an Afro-Caribbean lady who was successfully treated with intra-lesional (5FU) injection following the fourth operation. 19 The effective role of 5FU in halting pterygium recurrence has been discussed by others as well. 10,11 We have now adopted intra-lesional 5FU injection as a routine in the management of recurrent pterygium and report our results herein.…”

Section: Introductionmentioning

confidence: 99%

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Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Said

Faraj

El‐Alfy

et al. 2013

Eye

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Aim Recurrence is the most common complication arising from pterygium surgery. The aim of this study was to investigate the effectiveness of 5 fluorouracil (5FU) in halting the recurrence of pterygium after surgical excision. Methods A retrospective review of patients treated for pterygium recurrence was carried out. Patients with recurrent (secondary) pterygium were treated with multiple weekly intra-lesional injections of 0.1-0.2 ml (2.5-5 mg) 5FU post-operatively depending on the size of the recurrence. The treatment was started within 1 month from the date of recurrence. The time from surgery to start of recurrence, previous treatment modalities, and number of recurrences were documented. The number of injections required to induce arrest of progression and/ or regression of vascularity and fleshiness of the pterygium and any complications related to 5FU treatment were examined. Results Fifteen eyes from 14 patients with recurrent pterygium treated with intralesional 5FU injections were analysed. Three of the 15 eyes had undergone a secondary excision and 12 had undergone a primary excision. In all, 93.3% of patients showed regression of the fibrovascular tissue (thickness and vascularity) and arrest of progression following a dose of 0.1-0.2 ml (2.5-5 mg) 5FU. Twelve eyes required three injections or fewer, whereas one patient required eight injections. This beneficial effect was maintained over an average follow-up period of 17 months. No complications from 5FU were observed. Conclusion The use of weekly intra-lesional 5FU injections for the treatment of recurrent pterygium is safe and effective in limiting the progression and inducing the regression of recurrent pterygium. The number of injections can be tailored according to clinical need.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Said

Faraj

El‐Alfy

et al. 2013

Eye

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“…The frequency of pterygia and the apparition of recurrences justify the rising number of reports published in indexed journals (over 150 reports during the past 2 years). The great interest raised by this condition is demonstrated by the number of surgical approaches for pterygium,4 associated with antimetabolites, either topical,5 or subconjunctival,6 radiotherapy,7 conjunctival and limbal grafts,8 amniotic membrane transplantation and even photodynamic therapy 9…”

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confidence: 99%

Efficacy of mitomycin C associated with direct conjunctival closure and sliding conjunctival graft for pterygium surgery

Hoz¹,

Montero²,

Alió

et al. 2007

British Journal of Ophthalmology

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“…Several studies are reported about the use of 5-FU and MMC in pterygium surgery with different results (9)(10)(11)14). Any direct comparison of clinical trials is difficult because of the variability of confounding factors such as differences in the dose and duration of application of the drugs, whether the pterygium is primary or secondary, type of pterygium, differences in the definition of recurrence, and differences in follow-up periods.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative application of 5-fluorouracil and mitomycin C aschemoadjuvants in primary pterygium surgery

Altay

Balta

2016

Turk J Med Sci

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IntroductionPterygium is defined as an extension of fibrovascular growth from the conjunctiva onto the cornea. It can cause chronic irritative symptoms, cosmetic problems, and vision impairment (1,2).Many surgical techniques have been developed for the treatment of pterygium. However, the recurrence rates are between 24% and 89% following simple pterygium excision (1-6). Because of these high recurrence rates, the use of adjunct therapies such as beta radiation, antimetabolites like mitomycin C (MMC) and 5-fluorouracil (5-FU), and conjunctival autograft has been advocated.Direct comparisons between studies is difficult for various reasons, including a wide range of sample sizes, whether primary or recurrent pterygia were studied, and differences in the definition of pterygium recurrence and follow-up periods. These reasons contribute to the conflicting results that are sometimes observed in different studies (7).The main objective of this study was to compare concurrent intraoperative 5-FU or MMC application with simple excision in the treatment of primary pterygium in terms of recurrence prevention. Materials and methodsNinety-three patients with primary pterygium (47 women and 46 men) who underwent surgery were included. Indications for surgery were chronic irritation, cosmetic problems, and vision impairment.At the initial visit all patients were examined, and the size and location of pterygia were defined. Pterygia were classified as atrophic type (type 1), noninflamed type (type 2), and inflamed type (type 3) according to clinical appearance. If the pterygium tissue was densely vascularized, hyperemic, and edematous, it was classified as inflamed. If the pterygium was less vascularized, nonedematous, and without edema, then it was classified as noninflamed. The atrophic type was defined as a pterygium with minimal vascularization, without hyperemia, and without edema.Patients were divided into three groups based on treatment protocol (5-FU, MMC, and control). The same Background/aim: To compare the effectiveness of intraoperative 5 fluorouracil (5-FU) and mitomycin C (MMC) application in preventing recurrence following primary pterygium excision. Materials and methods:This was a prospective clinical trial that included 93 patients with primary pterygia assigned to three treatment groups in which 29 patients received an intraoperative application of 25 mg/mL 5-FU for 5 min, 32 patients received an intraoperative application of 0.02% MMC for 5 min, and 32 patients underwent only surgical excision (the control group). Follow-up visits were done on postoperative days 1, 3, 7, 15, and 30, and then every month.Results: After a mean follow-up of 14 months, the surgical excision recurrence rates in the 5-FU, MMC, and control groups were 27.6%, 12.5%, and 43.75%, respectively. There was a statistically significant difference in the 5-FU and MMC groups when compared with the control group (chi-square; P = 0.04); however, the difference between the 5-FU and MMC groups was not significant. No serious complications were ...

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Postoperative subconjunctival 5-fluorouracil in the management of recurring pterygium

Cited by 17 publications

References 11 publications

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Intra-lesional 5 fluorouracil for the management of recurrent pterygium

Efficacy of mitomycin C associated with direct conjunctival closure and sliding conjunctival graft for pterygium surgery

Intraoperative application of 5-fluorouracil and mitomycin C aschemoadjuvants in primary pterygium surgery

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