Segurança e efetividade no tratamento do pterígio usando infiltração de 5-fluoruracila no intraoperatório

Valezi, Vanessa Grandi; Schellini, Silvana Artioli; Viveiros, Magda Massae Hata; Padovani, Carlos Roberto

doi:10.1590/s0004-27492009000200007

Cited by 10 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 121 According to a series of 125 eyes receiving intraoperative 5-FU (at a dose of 25 mg/mL), pterygia recurred in 36%. 122 Higher doses of 5-FU (50 mg/mL) lead to a recurrence decrease at around 11%, with no statistically significant advantages when compared with conjunctival autografting alone. 121 Although there is little evidence in the literature to encourage a routinely 5-FU use for this surgery, this adjuvant treatment appears to maintain a role in treating recurrent pterygia.…”

Section: Adjuvant Therapiesmentioning

confidence: 91%

How to minimize pterygium recurrence rates: clinical perspectives

Nuzzi¹,

Tridico²

2018

OPTH

View full text Add to dashboard Cite

The main treatment for pterygium is surgical removal. However, pterygium surgery is concerned with high rates of postoperative recurrence. Predicting factors of recurrence are not fully understood, yet, but they probably depend on a multitude of patient-related, clinical, and/or surgical factors. Several adjuvant treatments have been proposed to reduce postoperative pterygium recurrence, including different antimetabolites, antiangiogenetic factors, and radiation therapy. The purpose of this review is to collect the current evidence regarding application and limits of different therapeutic approaches for preventing postoperative recurrence of pterygium, giving insights and perspectives for better management of this disease. In the light of the current evidence, pterygium surgery cannot disregard wound coverage with conjunctival autografting or rotational flap combined with adjuvant treatments. The rotational flap technique is associated with shorter surgical time rates and prevents graft displacement and necrosis, given its vascular pedicle. Amniotic membrane may still be reserved in case of great conjunctival defects or insufficient conjunctiva. Repeated subconjunctival antivascular endothelial growth factor injections can be considered as an effective and safe adjuvant treatment. Moreover, management of postoperative pain is crucial. Innovative treatment strategies will probably target different molecular pathways, considering recent findings regarding pterygium pathogenesis, to improve better understanding and develop universally shared guidelines. Great importance shall be dedicated to the identification of novel molecular biomarkers and favoring factors of recurrence, in order to achieve a customized surgical treatment for each patient and obtain maximal reduction of postoperative recurrence.

show abstract

Section: Adjuvant Therapiesmentioning

confidence: 91%

How to minimize pterygium recurrence rates: clinical perspectives

Nuzzi¹,

Tridico²

2018

OPTH

View full text Add to dashboard Cite

show abstract

“…Kaplan-Meier survival analysis showed that the recurrence-free period of pterygium in the 5-FU group was significantly (P = 0.005) longer than that of the control group. One study by Valezi et al suggests that intraoperative infiltration of 5-FU is safe for treatment of pterygium and there is no statistically significant difference between the intraoperative and topical of application of 5-FU, however, the high recurrence rate indicated that other studies would be necessary to show the concentration/dose to better prevent it [18]. Ibrahim and Nada demonstrated that the infiltration of 5-FU rather than topical application as an adjuvant to pterygium surgery is easy, time saving, and does not necessitate copious irrigation with saline as with topical application with comparable results and postoperative complications [19].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of 5-Fluorouracil in the Treatment of Pterygium

Shah¹,

Ahmed²,

Badar³

et al. 2021

Cureus

View full text Add to dashboard Cite

To determine the efficacy of 5-Fluorouracil (FU) in the treatment of pterygium. Methodology After meeting the inclusion criteria 101 patients were enrolled in this study. Informed consent and demographic information was taken from all the patients. Patients underwent ophthalmic clinical examination that included slit lamp examination to grade pterygium. Before starting 5-FU injections, all topical medication was stopped. After four weeks the effects of 5-FU and its efficacy was noted. The patients were reviewed again after six months to note any recurrence. All the collected data was entered and analyzed on Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY). Results In our study the mean age of the patients was 37.74 ± 10.15 years, male to female ratio of the patients was 1.06:1. The primary type of pterygium was noted in 54 (53.5%) and recurrent was noted in 47 (46.5%) patients. The efficacy achieved in 88 (87.13%) patients, four had recurrence of pterygium and of 101 patients 26 underwent surgical excision. Conclusion The use of 5-FU is safe and effective for the treatment of pterygium and it can be implemented as a primary treatment especially in the hot temperate zone where it is very common and aggressive with high recurrence rate. 5-FU not only halts its progression but also reduces the size and vascularity thus decreasing the need for surgery and steroid use and preventing recurrence.

show abstract

“…To reduce the recurrence risk, beta radiation with strontium-90, and triethylene thiophosphoramide (thiotepa) and 5-FU were used as adjuvant treatments for the bare sclera technique. 128 – 132 Most of these adjuvant options have been abandoned due to the presence of safer and more effective alternatives.…”

Section: Surgical Management Of Pterygiummentioning

confidence: 99%

Pterygium: an update on pathophysiology, clinical features, and management

2021

View full text Add to dashboard Cite

Pterygium is a relatively common ocular surface disease. The clinical aspects and the treatment options have been studied since many years ago, but many uncertainties still exist. The core pathologic pathway and the role of heredity in the development of pterygium are still attractive fields for the researchers. The role of pterygium in corneal irregularities, in addition to the refractive properties of pterygium removal, has been increasingly recognized through numerous studies. The association between pterygium and ocular surface neoplasia is challenging the traditional beliefs regarding the safe profile of the disease. The need for a comprehensive clinical classification system has encouraged homogenization of trials and prediction of the recurrence rate of the pterygium following surgical removal. Evolving surgical methods have been associated with some complications, whose diagnosis and management are necessary for ophthalmic surgeons. According to the review, the main risk factor of pterygium progression remains to be the ultraviolet exposure. A major part of the clinical evaluation should consist of differentiating between typical and atypical pterygia, where the latter may be associated with the risk of ocular surface neoplasia. The effect of pterygium on astigmatism and the aberrations of the cornea may evoke the need for an early removal with a purpose of reducing secondary refractive error. Among the surgical methods, conjunctival or conjunctival-limbal autografting seems to be the first choice for ophthalmic surgeons because the recurrence rate following the procedure has been reported to be lower, compared with other procedures. The use of adjuvant options is supported in the literature, where intraoperative and postoperative mitomycin C has been the adjuvant treatment of choice. The efficacy and safety of anti–vascular endothelial growth factor agents and cyclosporine have been postulated; however, their exact role in the treatment of the pterygium requires further studies.

show abstract

Segurança e efetividade no tratamento do pterígio usando infiltração de 5-fluoruracila no intraoperatório

Cited by 10 publications

References 16 publications

How to minimize pterygium recurrence rates: clinical perspectives

How to minimize pterygium recurrence rates: clinical perspectives

Efficacy of 5-Fluorouracil in the Treatment of Pterygium

Pterygium: an update on pathophysiology, clinical features, and management

Contact Info

Product

Resources

About