Photodynamic therapy for wound-healing modulation in pterygium surgery. A clinical pilot study.
BACKGROUND
This study was performed to evaluate the safety and efficacy of photodynamic therapy with the carboxyfluorescein ester BCECF-AM as an adjunctive treatment procedure for pterygium surgery to reduce the rate of recurrence.


METHODS
In this nonrandomized prospective clinical trial, 19 eyes with nasally located primary pterygium were examined. All eyes were treated with the bare sclera surgical technique. Seven eyes received in addition treatment with BCECF-AM solution and blue light. All patients were evaluated at least after 1 day, 1 week, 1 month, 3 months, and 1 year. Postoperative fibrovascular growth from the limbus of at least 1 mm was defined as recurrence.


RESULTS
The intraoperative application of BCECF-AM solution did not cause anterior chamber flare or any other significant side effects. The bare sclera surgery rate of recurrence was 0% (zero of 12) after 3 months and 91% (11 of 12) after 1 year. The additional photodynamic therapy treatment had a rate of recurrence of 14.2% (one of seven) after 3 months and 71.4% (five of seven) after 1 year.


CONCLUSIONS
The applied PDT technique seems to be a safe procedure but is associated with a high rate of recurrence. In conclusion, the evaluated PDT treatment procedure, at this point, should not be considered. As we found a high rate of recurrence also in the control group, the bare sclera technique is not effective, even in primary pterygia.
Hueber
Arno
A
Department of Anterior Segment Surgery, Center of Ophthalmology, University of Cologne, Kerpener Str. 62, 50924 Köln, Germany. Arno.Hueber@Uni-Koeln.de
Grisanti
Salvatore
S
Diestelhorst
Michael
M
D003131:Combined Modality Therapy; D005260:Female; D005452:Fluoresceins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D005452:Fluoresceins; D017319:Photosensitizing Agents; C057433:2',7'-bis-(2-carboxyethyl)-5(6)-carboxyfluorescein acetoxymethyl ester