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Intense 5-FU injection may prevent recurrence after pterygium surgery
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Intense treatment with repeated injections of 5-fluorouracil showed safety and efficacy in the treatment of recurrent pterygium following excision surgery.
Fifteen patients with active recurrent pterygium were involved in the study. All eyes had previously undergone surgical excision with conjunctival autograft, and the majority of them had corneal invasion.
Impression cytology of the lesion showed decrease or absence of goblet cells in 73% of the cases and absence of epithelial cells in 27% of the cases. All eyes had some degree of squamous metaplasia on the cornea, on the lesion and on the conjunctiva.
Patients received 5-FU intralesional injections once a week for a total of 10 injections. The positive effect of the treatment was seen on impression cytology as an increase in the number of epithelial cells or reappearance of epithelial cells in eyes where no cells were present at baseline. Goblet cell increased in about half of the cases over the entire ocular surface. Squamous metaplasia decreased significantly in the majority of eyes.
Symptoms of dry eye and conjunctival redness improved to some degree in all the patients. Pterygium excision with conjunctival autograft surgery was performed in eight patients for cosmetic reasons. No case of recurrence was reported.
“The recovery of conjunctival goblet cells and the improvement of squamous metaplasia during our study’s follow-up period is not only a sign of 5-FU safety, but it also suggests a possible restorative role that helps to recover the lost balance in both cell populations – epithelial and goblet cells – after pterygium surgery,” the authors wrote. – by Michela Cimberle
Disclosure: None of the authors reported a relevant financial disclosure.
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