Inhibiting COX-2 expression may halt recurrence after pterygium removal, study suggests

Fibroblastic proliferation appears to persist after the removal of pterygia and can contribute to recurrence, a study by researchers in Turkey found.

"As a result, in the light of these findings, we think that after pterygium excision, selective [cyclooxygenase-2] inhibitors may be helpful to prevent recurrence," the study authors said.

Nermin Karahan, MD, and colleagues examined the immunohistochemical expression of cyclooxygenase-2 (COX-2) among 21 primary pterygia and 12 recurrent pterygia from patients undergoing pterygium surgery and six normal corneal-scleral tissue specimens.

The investigators found that COX-2 was expressed in fibroblasts in 14 primary pterygium cases and in all recurrent pterygia cases.

There was, however, a statistically significant difference in COX-2 expressions in fibroblasts between primary and recurrent pterygium cases ( P = .001).

"In all the recurrent pterygium cases, COX-2 showed strong expression," the authors said.

There were statistically significant differences in COX-2 expressions in surface epithelium (P = .028) and stromal inflammatory cells (P = .000) between control tissues and primary pterygia tissues.

The researchers also found statistically significant differences in COX-2 expressions in surface epithelium (P = .000), stromal fibroblasts (P = .000), vessels (P = .027) and inflammatory cells (P = .001) between control tissues and recurrent pterygia tissues, according to the study, published in the July-August issue of Indian Journal of Ophthalmology.