Intraoperative infiltration against topical application of 5-fluorouracil in pterygium treatment

Abstract

Purpose The aim of this study was to compare the efficacy and safety of intraoperative infiltration versus topical application of 5-fluorouracil (5-FU) as an adjuvant drug in pterygium treatment. Design The study design was a prospective interventional comparative case series. Patients and methods A total of 100 consecutive cases of pterygia in 95 patients (64 primary and 36 recurrent) were subjected to pterygium excision with the bare sclera technique. The cases were equally divided into two groups (A and B) according to the method of application of the adjuvant 5-fluorouracil (5-FU). Group A included fifty eyes and received intraoperative infiltration of 0.5 ml of 5-FU (50 mg/ml) at the end of the surgical procedure. Group B included fifty eyes and received intraoperative topical application of 5-FU (50 mg/ml) for 5 min during the surgical procedure. Postoperative follow-up was carried out at days 1, 7 and 14, and monthly thereafter for at least 6 months. Postoperative regrowth of fibrovascular tissue crossing the limbus was defined as recurrence. Data were evaluated and statistically analyzed. Results All the pterygia were in a nasal location and all the treated pterygia extended 2 mm or more into the cornea. Postoperatively, pterygium recurrence was observed in 14% in group A and 20% in group B, a statistically insignificant difference (P>0.05). With regard to postoperative complications, the difference was also statistically nonsignificant (P>0.05). Conclusion Infiltration of 5-FU rather than topical application as an adjuvant to pterygium surgery is easy, time saving, and does not necessitate copious irrigation with saline as with topical application with comparable results and postoperative complications.

Keywords

• 5-fluorouracil
• infiltration
• pterygium