Postoperative subconjunctival corticosteroid injection to prevent pterygium recurrence.
OBJECTIVE
To report the outcome of postoperative subconjunctival injection of triamcinolone in eyes that underwent pterygium surgery and were at risk for recurrence.


METHODS
Twelve eyes of 11 patients with primary (7 eyes) or recurrent (5 eyes) pterygia underwent excision and conjunctival autografting (4 eyes, 33.3%), amniotic membrane grafting (6 eyes, 50%), or both (2 eyes, 16.6%). All of these eyes had signs that were considered to be risk factors for recurrence (conjunctival inflammation, hemorrhage, granuloma, and fibrovascular proliferation); accordingly, they also underwent subconjunctival injection of triamcinolone.


RESULTS
Among the 11 patients, there were 8 (72.7%) men and 3 (27.3%) women; the mean age was 41 years (range, 20-56 years). In 5 (41.7%) eyes, the pterygium was graded as T2 (intermediate) and in 7 (58.3%) eyes was graded as T3 (fleshy). The time between surgery and the first injection ranged from 2 to 5 weeks (mean, 3.4 weeks), and 1-3 injections were necessary (mean, 1.7) to achieve the desired effect. After injection, 1 (8.3%) eye developed inflammation, and 2 (16.7%) eyes from another patient developed intraocular hypertension that was controlled with a topical beta-blocker. The follow-up after the last injection ranged from 8 to 36 months (mean, 14.5 months); only 1 recurrence (grade 3) occurred during this period.


CONCLUSIONS
The postoperative use of subconjunctival triamcinolone seems to benefit patients at increased risk of pterygium recurrence. It is relatively safe and is accompanied by few complications, but controlled and prospective studies are necessary to confirm its efficacy.
Paris
Fabiana dos Santos
Fdos S
Ocular External Diseases and Cornea Service, Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. fabiana.s.p@pop.com.br
de Farias
Charles Costa
CC
Melo
Gustavo Barreto
GB
Dos Santos
Myrna Serapião
MS
Batista
Jefferson Luiz Alves
JL
Gomes
José Alvaro Pereira
JA
D000328:Adult; D000650:Amnion / Q000637:transplantation; D003228:Conjunctiva / Q000187:drug effects* / Q000637:transplantation; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D011625:Pterygium / Q000517:prevention & control* / Q000601:surgery*; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide