title: Preoperative tranilast as adjunctive therapy to primary pterygium surgery with a 1-year follow-up.
abstract: OBJECTIVE
  To determine the efficacy of tranilast as an adjunctive therapy in conjunctival autograft.
  
  
  METHODS
  Twenty-nine patients were randomly allocated to the Tranilast Group (n=15) or the Control Group (n=14). The Tranilast Group received a subconjunctival injection of 0.5% tranilast 30 days prior to surgery. Conjunctival autograft was performed in both groups using fibrin sealant and 0.02% subconjunctival mitomycin C at the end of the surgery. After the resection of the pterygium, immunohistochemistry was performed with 100 cells to identify epithelial cells positive for transforming growth factor-β (TGF-β). Subjective symptoms were evaluated using a 5-point scale, and the recurrence rate was assessed.
  
  
  RESULTS
  Both groups showed improvements in their symptoms and similar clinical results. Compared with the Control Group, the Tranilast Group failed to show a decreased recurrence rate (p=0.59). However, the number of epithelial cells expressing TGF-β was lower in the Tranilast Group (5 cells; 95% CI: 2.56-13.15; Control Group, 16 cells, 95% CI: 11.53-24.76; p=0.01). Minimal but reversible complications, including glaucoma secondary to corticosteroids and granuloma, occurred during the study.
  
  
  CONCLUSIONS
  Tranilast was effective in decreasing the number of pterygium epithelial cells expressing TGF-β.
authors.affiliation: Department of Surgery, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Gildásio C
authors.initials: GC
authors.lastname: Almeida Junior
authors.affiliation: Department of Surgery, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Luciano
authors.initials: L
authors.lastname: Arakawa
authors.affiliation: Department of Pathology, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Dalísio de
authors.initials: Dd
authors.lastname: Santi Neto
authors.affiliation: Department of Pathology, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Patrícia Maluf
authors.initials: PM
authors.lastname: Cury
authors.affiliation: Department of Ophthalmology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Acácio A S
authors.initials: AA
authors.lastname: Lima Filho
authors.affiliation: Department of Ophthalmology, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Sidney J F
authors.initials: SJ
authors.lastname: Sousa
authors.affiliation: Department of Ophthalmology, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Milton R
authors.initials: MR
authors.lastname: Alves
authors.affiliation: Deparftment of Anatomy, Histology and Embryology, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Azoubel
mesh_terms: D000328:Adult; D064592:Autografts; D003228:Conjunctiva / Q000187:drug effects / Q000378:metabolism / Q000637:transplantation*; D004847:Epithelial Cells / Q000187:drug effects* / Q000378:metabolism; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D011625:Pterygium / Q000188:drug therapy* / Q000378:metabolism / Q000517:prevention & control / Q000601:surgery*; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods; D016212:Transforming Growth Factor beta / Q000378:metabolism*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D062367:ortho-Aminobenzoates / Q000008:administration & dosage*
chemical_list: D015718:Fibrin Tissue Adhesive; D016212:Transforming Growth Factor beta; D062367:ortho-Aminobenzoates; D016685:Mitomycin; C012293:tranilast