5-fluorouracil injection in recurrent pterygium

Poster Details

First Author: A.Azevedo PORTUGAL

Co Author(s):    C. Pedrosa   S. Pina   M. Ramalho   P. P   B. Feij   I. Prieto

Abstract Details

Purpose:

To report the efficacy of subconjunctival 5-fluorouracil (5-FU) injection in halting the progression of recurrent pterygium in three patients.

Setting:

Department of Ophthalmology Prof. Doutor Fernando Fonseca, Lisbon, Portugal

Methods:

Three patients with recurrent pterygium were submitted to subconjunctival injection of 2,5 mg of 5-FU into the dome of the fibrovascular tissue using a 27-gauge needle mounted in a 1-ml syringe. The initial surgery had consisted of simple excision with intraoperative mitomycin C or excision with grafting. Recurrence time was 2 months after pterygium surgery and corneal invasion was less than 2 mm at the time of the injection. The first 5-FU injection was performed 2 to 6 months after the excision surgery and patients received one to six injections according to the response obtained. Patient workup included anterior segment photographs pre- and postoperative.

Results:

The clinical appearance of the surgical area improved with reduction of conjunctival hyperemia and thickness. This effect was more prominent in the patients injected right after recurrence detection (2 months after initial surgery). Symptoms of ocular irritation also decreased after treatment. One patient developed mild punctuate epithelial erosion that resolved after lubrication and no severe complications occurred. There was no progression of the lesion for a maximum follow-up time of 18 months after the last injection.

Conclusions:

Recurrence is the most common undesirable outcome of pterygium excision and seems to be related to fibroblastic proliferation. The more often the surgery is performed, the more likely it is that the pterygium will recur. 5-FU is an antifibrotic agent that inhibits DNA synthesis and thereby decreases fibroblastic activity. Intralesional injection of 5-FU in recurrent pterygium was effective in reducing the progression of the fibrovascular tissue, the conjunctival injection and symptoms. Therefore it helps to avoid repetitive surgery. FINANCIAL DISCLOSURE?: No