5-Fluorouracil versus mitomycin C as adjuncts to conjunctival autograft in preventing pterygium recurrence.

Abstract

To compare the efficacy of 5-fluorouracil (5-FU) with mitomycin C (MMC) in preventing pterygium recurrence when used as an adjuvant following pterygium excision with conjunctival autograft. Low-dose MMC combined with conjunctival autograft is an effective treatment for preventing recurrence following pterygium excision, but safety, cost, and availability limit its use in developing countries. There is a paucity of data on the efficacy of 5-FU when used in Africa as an adjuvant to conjunctival autograft following pterygium excision. This is a randomized controlled prospective trial using either 50 mg/ml 5-FU or 0.01% MMC. Eighty eyes of 80 subjects were studied. Forty-six subjects with a mean age 49.8 ± 13.8 years were treated with 5-FU (USD 13.0 per unit), while 34 patients with a mean age 51.9 ± 12.1 years were treated with MMC (USD 20.0 per unit). There was no significant difference in mean age between the two groups (p = 0.48). The ratio of male to female patients in both groups was similar at 0.92:1 for the 5-FU group and 1:1 for the MMC group (p = 0.85). Mean follow-up period was 35.2 ± 29.1 weeks. Recurrence rate in the 5-FU group was 8.7% compared to 11.8% in the MMC group (recurrence risk ratio = 0.71, 95% CI 0.17-3.1, p = 0.7). One patient from the MMC-treated group had corneoscleral melting. Other complications were mild and not sight threatening. In the prevention of pterygium recurrence, 5-FU appears to compare favorably with low-dose MMC when used as an adjuvant following pterygium excision and conjunctival autograft. Further studies are required to assess the long-term effect of using 5-FU in such cases.

• Authors: Charles O Bekibele, Adeyinka Ashaye, Bolutife Olusanya, Aderonke Baiyeroju, Oluyemi Fasina, Adekunmi O Ibrahim, Olufunmi Ogun
• Journal: International ophthalmology (Int Ophthalmol) Vol. 32 Issue 1 Pg. 3-8 (Feb 2012) ISSN: 1573-2630 [Electronic] Netherlands
• PMID: 22246200 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibiotics, Antineoplastic
• Immunosuppressive Agents
• Ophthalmic Solutions
• Mitomycin
• Fluorouracil

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibiotics, Antineoplastic (administration & dosage)
• Conjunctiva (transplantation)
• Female
• Fluorouracil (administration & dosage)
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Ophthalmic Solutions
• Ophthalmologic Surgical Procedures (methods)
• Postoperative Care (methods)
• Prospective Studies
• Pterygium (pathology, therapy)
• Secondary Prevention
• Transplantation, Autologous
• Treatment Outcome
• Wound Healing (drug effects)
• Young Adult