Efficacy of Subconjunctival 5-Fluorouracil and Triamcinolone Injection in Impending Recurrent Pterygium
ภิญนิตา ประภาสะวัต, Nattaporn Tesavibul, Kanjana Leelapatranura, Teeranit Phonjan
Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
ObjectiveTo study the efficacy of subconjunctival 5-fluorouracil (5-FU) and triamcinolone injection in halting the progression of impending recurrent pterygium.DesignRandomized, prospective, controlled clinical trial.ParticipantsOne hundred nine patients who had undergone pterygium excision within the previous 6 months and developed grade 3 characteristics (impending recurrent pterygium).MethodsA total of 109 eyes with impending recurrent pterygium were stratified randomly into 3 groups by treatment: 35 eyes served as the control group, 39 eyes received a 5-mg intralesional injection of 5-FU weekly for 2 weeks, and 35 eyes received one 20-mg intralesional injection of triamcinolone. All groups received 1% prednisolone acetate eye drops 4 times daily for 8 weeks.Main Outcome MeasuresRecurrence rate, success rate, and survival analysis were compared among the groups.ResultsWith a mean follow-up time of 10.9±5.5 months (range, 6–26 months), the success rates of the 5-fluorouracil and triamcinolone groups were higher than the control group (87.2%, 71.4%, and 48.6%, respectively). 5-fluorouracil was significantly (P = 0.001) more effective in inhibiting the recurrence of pterygium compared with the control group at all time points during follow-up. Kaplan–Meier survival analysis showed that the recurrence-free period of pterygium in the 5-FU group was significantly (P = 0.005) longer than that of the control group but not in the triamcinolone group compared with the controls (P = 0.063). There was no significant difference between the 5-FU group and the triamcinolone group (P = 0.362). Minimal reversible complications such as steroid-induced glaucoma and superficial punctate epitheliopathy developed during the study.ConclusionsIntralesional injection of 5-FU and triamcinolone was more effective in inhibiting the recurrence of pterygium than topical steroid alone, with the results in the 5-FU group reaching statistical significance.
Ophthalmology ปี 2549, July ปีที่: 113 ฉบับที่ 7 หน้า 1102-1109