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.
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References
Cameron ME (ed) (1965) Pterygium throughout the world. Charles C. Thomas, Springfield
Ashaye AO (1991) Pterygium in Ibadan. West Afr J Med 10(3):232–243
Amano SA, Motoyama YA, Oshika TA et al (2000) Comparative study of intraoperative mitomycin C and beta irradiation in pterygium surgery. Br J Ophthalmol 84(6):618–621
Pikkel J, Porges Y, Ophir A (2001) Halting pterygium recurrence by postoperative 5-fluorouracil. Cornea 20(2):168–171
Morrow GL, Stein RM, Heathcote JG et al (1994) Ocular toxicity of mitomycin C and 5-fluorouracil in the rabbit. Can J Ophthalmol 29(6):268–273
Prabhasawat P, Barton K, Tseng SCG (1997) Comparison of conjunctival auto grafts, amniotic membrane grafts and primary closure for pterygium excision. Ophthalmology 104(6):974–985
Frucht-Perry J, Raiskup F, Ilsar M et al (2006) Conjunctival autografting combined with low-dose mitomycin C for prevention of primary pterygium recurrence. Am J Ophthalmol 141:1044–1050
de la Hoz F, Montero JA, Alio JL et al (2008) Efficacy of mitomicin C associated with direct conjunctival closure and sliding conjunctival graft for pterygium surgery. Br J Ophthalmol 92(2):175–178
Bekibele CO, Baiyeroju AM, Olusanya BA et al (2008) 5FU vs conj autograft in pterygium treatment. Eye 22(1):31–34
Mutlu FM (1999) A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology 106(4):817–821
Rahman A, Yahya K, Hasan KS (2008) Recurrence rate of pterygium following surgical excision with intraoperative versus postoperative mitomycin-C. J Coll Physicians Surg Pak 18(8):489–492
Jain V (2008) Surgically induced necrotizing scleritis after pterygium surgery with conjunctival autograft. Cornea 27(6):720–721
Sridhar MS, Bansal AK, Rao GN (2002) Surgically induced necrotizing scleritis after pterygium excision and conjunctival autograft. Cornea 21(3):305–307
Viveiros MM, Schellini SA, Candeias J et al (2007) Exposure of normal Tenon’s capsule fibroblasts from pterygium to 5-fluorouracil and mitomycin C. Arq Bras Oftalmol 70(1):73–77
Mearza AA, Aslanides IM (2007) Uses and complications of mitomycin C in ophthalmology. Expert Opin Drug Saf 6(1):27–32
Mora JS, Nguyen N, Iwach A et al (1996) Trabeculectomy with intraoperative sponge 5-fluorouracil. Ophthalmology 103(6):963–970
Abraham LM, Selva D, Casson R et al (2007) The clinical applications of fluorouracil in ophthalmic practice. Drugs 67(2):237–255
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This study was sponsored by the University of Ibadan Senate research grant SRG/COM/2006/21A.
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Bekibele, C.O., Ashaye, A., Olusanya, B. et al. 5-Fluorouracil versus mitomycin C as adjuncts to conjunctival autograft in preventing pterygium recurrence. Int Ophthalmol 32, 3–8 (2012). https://doi.org/10.1007/s10792-011-9509-x
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DOI: https://doi.org/10.1007/s10792-011-9509-x