Efficacy of Subconjunctival 5-Fluorouracil and Triamcinolone Injection in Impending Recurrent Pterygium
Received 17 August 2005; accepted 16 February 2006. published online 25 May 2006.
Objective
To study the efficacy of subconjunctival 5-fluorouracil (5-FU) and triamcinolone injection in halting the progression of impending recurrent pterygium.
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.
Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Correspondence to Pinnita Prabhasawat, MD, Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Manuscript no. 2005-777.
The authors have no proprietary interest in any aspect of the study.
ABSTRACT