Efficacy of 5-Fluorouracil in the Treatment of Pterygium

Abstract

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.

Sub-conjunctival injection of 5 Fluorouracilversus Bevacizumab in Treatment of Primary Pterygium

“…2 Although, the study conducted by Shah et al, had demonstrated no such adverse effect, our study revealed 3 cases of punctate epithelial keratitis in 5FU group but no such event was seen in Bevacizumab group. 3 Our study demonstrated the superior efficacy of 5FU as sole therapy in improving the clinical appearance of primary pterygium as compared to Bevacizumab, as reduction in grade of pterygium was seen in 21 (65.6%) patients in 5FU group versus only 2 patients (6.3%) in Bevacizumab group. However, since no other known study comparing the efficacy of the two treatment modalities is available, further studies are recommended to reach a definitive conclusion.…”

“…All the patients who presented with primary pterygium were recruited in the study. The minimum required sample size was 64, calculated by using WHO sample size calculator, where proportion of successful outcome in terms of vascularity grade was considered to be 50%, proportion of successful outcome in exposed group was considered to be 86.7% 3 , with 80% study power, 95% level of confidence and 10% precision.…”

“…The Greek word "pterygium" describes the shape of overgrowth, which resembles an insect wing. 3 Apart from the cosmetic concern to the patient, pterygium causes visual disturbance by encroachment on the visual axis, astigmatic effect, ocular inflammation and restriction of ocular movements. 3,4 The exact pathophysiology of pterygium is not understood.…”

“…3 Apart from the cosmetic concern to the patient, pterygium causes visual disturbance by encroachment on the visual axis, astigmatic effect, ocular inflammation and restriction of ocular movements. 3,4 The exact pathophysiology of pterygium is not understood. However, known risk factors include exposure to ultraviolet-B radiation, inflammatory response, chemicals, trauma, dust and wind.…”

Pterygium Recurrence- Surgical and Adjuvant Therapies

“…Said et al conducted a study in which it was presented that 93.3% of cases hada reduction of fibrovascular tissue and halting of growth after 0.1-0.2 ml or 2.5-5 mg 5 FU [32]. Low dose intra-operative 5-FU effectiveness was studied by Maldonado et al and concluded that it was inefficient in preventing reoccurrence however it may be due to low dosage as well as time span of treatment suggesting that only one injection may not be sufficient [33]. It wasalsofound by a studythat 5-Fluorouracil injection intra lesional also improved cosmetic appearance of not only primary but of recurrentpterygia as well [25].…”