pterygium surgery

Purpose The aim of this study was to compare the efficacy and safety of intraoperative infiltration versus topical application of 5-fluorouracil (5-FU) as an adjuvant drug in pterygium treatment. Design The study design was a prospective interventional comparative case series. Patients and methods A total of 100 consecutive cases of pterygia in 95 patients (64 primary and 36 recurrent) were subjected to pterygium excision with the bare sclera technique. The cases were equally divided into two groups (A and B) according to the method of application of the adjuvant 5-fluorouracil (5-FU). Group A included fifty eyes and received intraoperative infiltration of 0.5 ml of 5-FU (50 mg/ml) at the end of the surgical procedure. Group B included fifty eyes and received intraoperative topical application of 5-FU (50 mg/ml) for 5 min during the surgical procedure. Postoperative follow-up was carried out at days 1, 7 and 14, and monthly thereafter for at least 6 months. Postoperative regrowth of fibrovascular tissue crossing the limbus was defined as recurrence. Data were evaluated and statistically analyzed. Results All the pterygia were in a nasal location and all the treated pterygia extended 2 mm or more into the cornea. Postoperatively, pterygium recurrence was observed in 14% in group A and 20% in group B, a statistically insignificant difference (P>0.05). With regard to postoperative complications, the difference was also statistically nonsignificant (P>0.05). Conclusion Infiltration of 5-FU rather than topical application as an adjuvant to pterygium surgery is easy, time saving, and does not necessitate copious irrigation with saline as with topical application with comparable results and postoperative complications.

Pterygium is an ocular surface condition commonly encountered in optometric practice. A prevalence study in Enugu, Nigeria recorded an occurrence of 206 (19.3%) amongst 615 motorcycle riders. This study is an outlook on Pterygium, current and emerging concepts of it’s etiology and pathogenesis and recent non-surgical management options for Pterygium. Several published articles, journals and textbooks from 2004 – 2019 were reviewed using relevant subheadings. In terms of etiology and pathogenesis, Pterygium has a strong correlation with ultraviolet radiation (UVR), alteration of matrix metalloproteinase in limbal and corneal tissues, UVR genetically mediated expression of various cytokines and growth factors, Oxidative stress, viruses and heredity. The traditional treatment of choice is surgical excision, although faced with high recurrence rate and post surgical complications. Dipyridamole, an anti-arrhythmic drug in a recent research has been employed in the management of Pterygium. Dipyridamole has been shown to possess anti-inflammatory, anti-proliferative and platelet inhibitory properties which makes it a novel prospective candidate to address the apparent multifaceted etiology of pterygia.