title: 5-Fluorouracil versus mitomycin C as adjuncts to conjunctival autograft in preventing pterygium recurrence.
abstract: To compare the efficacy of 5-fluorouracil (5-FU) with mitomycin C (MMC) in preventing pterygium recurrence when used as an adjuvant following pterygium excision with conjunctival autograft. Low-dose MMC combined with conjunctival autograft is an effective treatment for preventing recurrence following pterygium excision, but safety, cost, and availability limit its use in developing countries. There is a paucity of data on the efficacy of 5-FU when used in Africa as an adjuvant to conjunctival autograft following pterygium excision. This is a randomized controlled prospective trial using either 50 mg/ml 5-FU or 0.01% MMC. Eighty eyes of 80 subjects were studied. Forty-six subjects with a mean age 49.8 ± 13.8 years were treated with 5-FU (USD 13.0 per unit), while 34 patients with a mean age 51.9 ± 12.1 years were treated with MMC (USD 20.0 per unit). There was no significant difference in mean age between the two groups (p = 0.48). The ratio of male to female patients in both groups was similar at 0.92:1 for the 5-FU group and 1:1 for the MMC group (p = 0.85). Mean follow-up period was 35.2 ± 29.1 weeks. Recurrence rate in the 5-FU group was 8.7% compared to 11.8% in the MMC group (recurrence risk ratio = 0.71, 95% CI 0.17-3.1, p = 0.7). One patient from the MMC-treated group had corneoscleral melting. Other complications were mild and not sight threatening. In the prevention of pterygium recurrence, 5-FU appears to compare favorably with low-dose MMC when used as an adjuvant following pterygium excision and conjunctival autograft. Further studies are required to assess the long-term effect of using 5-FU in such cases.
authors.affiliation: Department of Ophthalmology, University College Hospital, Ibadan, Nigeria. Cob150@yahoo.com
authors.forename: Charles O
authors.initials: CO
authors.lastname: Bekibele
authors.forename: Adeyinka
authors.initials: A
authors.lastname: Ashaye
authors.forename: Bolutife
authors.initials: B
authors.lastname: Olusanya
authors.forename: Aderonke
authors.initials: A
authors.lastname: Baiyeroju
authors.forename: Oluyemi
authors.initials: O
authors.lastname: Fasina
authors.forename: Adekunmi O
authors.initials: AO
authors.lastname: Ibrahim
authors.forename: Olufunmi
authors.initials: O
authors.lastname: Ogun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D011625:Pterygium / Q000473:pathology / Q000628:therapy*; D055502:Secondary Prevention; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016685:Mitomycin; D005472:Fluorouracil