5-Fluorouracil as chemoadjuvant for primary pterygium surgery: preliminary report.
OBJECTIVE
To investigate the safety and efficacy of intraoperative application of 5-fluorouracil as an adjuvant in primary pterygium surgery and to evaluate the effect of postoperative subconjunctival 5-fluorouracil injections on the recurrent pterygium.


METHODS
Of 25 consecutive white patients, 28 eyes with primary pterygium underwent pterygium excision with intraoperative application of 5-fluorouracil (25 mg/mL for 3 minutes). The superior and inferior conjunctiva was approximated to cover the scleral bed within 1 mm of the limbus. Recurrence of pterygium was defined as postoperative fibrovascular growth more than 1 mm onto the cornea. Eyes with recurrence less than 2 mm were treated with subconjunctival 5-fluorouracil injections.


RESULTS
After a mean follow-up of 14.1 +/- 3.9 months (mean +/- standard deviation), 7 recurrences (25%) were observed. All recurrences were detected within 12 months. In 4 of 7 recurrences, the fibrovascular growths were less than 2 mm. We, therefore, performed subconjunctival 5-fluorouracil injections. In 3 (75%) of 4 recurrences, the fibrovascular growths became atrophic. No serious complications were observed during and after the surgery. However, superficial punctate keratitis, pain, and hyperemia were detected in all patients in the early postoperative period. As a result, of 28 eyes, 4 (14%) had unacceptable cosmetic results and growing recurrences.


CONCLUSIONS
This study suggests that intraoperative applications of 5-fluorouracil is both efficient and safe in the treatment of primary pterygium. Additionally, postoperative subconjunctival 5-fluorouracil injections may prevent the progression of fibrovascular tissue.
Akarsu
Cengiz
C
Department of Ophthalmology, School of Medicine, University of Kirikkale, Kirikkale, Turkey. cengizakarsu@hotmail.com
Taner
Pelin
P
Ergin
Ahmet
A
D000328:Adult; D003228:Conjunctiva; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D011182:Postoperative Care; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012008:Recurrence
D019384:Nucleic Acid Synthesis Inhibitors; D005472:Fluorouracil