Efficacy of subconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium.

Abstract

OBJECTIVE:

To study the efficacy of subconjunctival 5-fluorouracil (5-FU) and triamcinolone injection in halting the progression of impending recurrent pterygium.

DESIGN:

Randomized, prospective, controlled clinical trial.

PARTICIPANTS:

One hundred nine patients who had undergone pterygium excision within the previous 6 months and developed grade 3 characteristics (impending recurrent pterygium).

METHODS:

A total of 109 eyes with impending recurrent pterygium were stratified randomly into 3 groups by treatment: 35 eyes served as the control group, 39 eyes received a 5-mg intralesional injection of 5-FU weekly for 2 weeks, and 35 eyes received one 20-mg intralesional injection of triamcinolone. All groups received 1% prednisolone acetate eye drops 4 times daily for 8 weeks.

MAIN OUTCOME MEASURES:

Recurrence rate, success rate, and survival analysis were compared among the groups.

RESULTS:

With a mean follow-up time of 10.9+/-5.5 months (range, 6-26 months), the success rates of the 5-fluorouracil and triamcinolone groups were higher than the control group (87.2%, 71.4%, and 48.6%, respectively). 5-fluorouracil was significantly (P = 0.001) more effective in inhibiting the recurrence of pterygium compared with the control group at all time points during follow-up. 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 but not in the triamcinolone group compared with the controls (P = 0.063). There was no significant difference between the 5-FU group and the triamcinolone group (P = 0.362). Minimal reversible complications such as steroid-induced glaucoma and superficial punctate epitheliopathy developed during the study.

CONCLUSIONS:

Intralesional injection of 5-FU and triamcinolone was more effective in inhibiting the recurrence of pterygium than topical steroid alone, with the results in the 5-FU group reaching statistical significance.

• Authors: Pinnita Prabhasawat, Nattaporn Tesavibul, Kanjana Leelapatranura, Teeranit Phonjan
• Journal: Ophthalmology (Ophthalmology) Vol. 113 Issue 7 Pg. 1102-9 (Jul 2006) ISSN: 1549-4713 [Electronic] United States
• PMID: 16730066 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Antimetabolites, Antineoplastic
• Glucocorticoids
• Triamcinolone Acetonide
• Fluorouracil

Topics

• Adult
• Aged
• Antimetabolites, Antineoplastic (administration & dosage)
• Conjunctiva
• Disease Progression
• Female
• Fluorouracil (administration & dosage)
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Injections
• Injections, Intralesional
• Male
• Middle Aged
• Prospective Studies
• Pterygium (prevention & control, surgery)
• Recurrence
• Survival Analysis
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage)