THREE YEARS FOLLOW UP OF RECURRENT PTERYGIUM TREATED WITH INTRALESIONAL 5-FLUOROURACIL
Published 2023
- 27th ESCRS Winter Meeting
Reference: MP17
| Type: Presented Poster & Poster Submission
| DOI:
10.82333/55fp-2n36
Authors:
Alicia Garde* 1
, June Artaechevarria 2
, Rosa Gutierrez 1
, Nicolas Lopez 1
, Javier San Roman 2
, Jacobo Yañez 1
1Ophthalmology,Hospital General Universitario Gregorio Marañon,Madrid,Spain, 2Ophthalmology,Hospital Fundacion Jiménez Diaz,Madrid,Spain
Purpose
To report the 3-years outcomes of subconjunctival 5-fluorouracil (5-FU) for the treatment of recurrent pterygium.
Setting
The tertiary referral University Hospital Fundación Jiménez Díaz, Madrid, Spain
Methods
A retrospective study that included patients diagnosed of recurrent pterygium. All of them had previous confirmed histological pterygium diagnosis. Intralesional 0.1 ml (5 mg) of 5-FU was injected every 1-2 weeks until pterygium atrophy was achieved. In non-responding cases, new excision with autologous conjunctival transplant was performed. An oral informed consent about the off-label use of 5-FU was obtained in all patients. Complete ophthalmological evaluation was performed previously and during follow-up over three years, which included visual acuity, intraocular pressure, biomicroscopy, pterygium recurrence size measure and iconography.
Results
14 eyes from 13 patients were included. Twelve eyes had previously undergone a primary excision with conjunctival autograft, and two eyes had a secondary excision with intraoperative mitomycin use. A mean of 5 injections were administered per eye (range: 2 - 6). Follow-up time ranged from 18 to 36 months. 12 eyes showed progression arrest (85.7%), 13 presented regression of the thickness and vascularity (92.8%), and all referred symptoms´ improvement. One patient suffered a corneal ulcer, that solved with intense lubrication. One patient underwent new excision, with no new recurrence after it. No other adverse events were identified.
Conclusion
In our experience, intralesional 5-FU injections are a safe and effective treatment in halting the progression of recurrent pterygium. Not only they reduce the lesion, they also improve symptoms. We observed that effectiveness was also achieved in long-termed recurrences (more than three years), despite it is more effective the sooner the treatment is started. If new excision is needed, it may also reduce the rate of new recurrences. Further studies with larger number of patients and longer follow-ups should be performed in order to demonstrate these findings, and to evaluate the use of 5-FU as an adjuvant treatment before excision.