Pterygium treatment using 5-FU as adjuvant treatment compared to conjunctiva autograft.

Department of Ophthalmology, University college Hospital Ibadanu, Oyo, Nigeria.
Eye (Impact Factor: 1.82). 01/2008; 22(1):31-4. DOI: 10.1038/sj.eye.6702480
Source: PubMed

ABSTRACT The use of conjunctiva autograft, adjunct antimetabolite therapy has been shown to be effective in preventing pterygium recurrence.
To compare 5 fluorouracil (5-FU) to conjunctival autograft in the treatment of large, fleshy pterygium.
A randomised controlled prospective study of outcome of pterygium treatment using 5-FU as adjuvant treatment compared to conjunctiva autograft. Thirty-five eyes with large pterygium treated with bare sclera conjunctival excision plus 5-FU were compared with 33 eyes treated with excision and conjunctival autograft alone.
Post-operative pterygium recurrence was observed in four (11.4%) eyes treated with 5-FU and 4 (12.1%) eyes treated with conjunctiva autograft (P>0.05). The post-operative complications included, granuloma formation 11.4% for 5-FU and 3.0% for autograft and conjunctival discharge 5.7% for 5-FU group only.
5-FU is marginally superior to conjunctival autograft in the prevention of pterygium recurrence but neither gives a more desirable single digit recurrence rate. Randomised studies combining both conjunctival autograft and 5-FU in pterygium treatment is advocated to further explore their effect.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: AimRecurrence is the most common complication arising from pterygium surgery. The aim of this study was to investigate the effectiveness of 5 fluorouracil (5FU) in halting the recurrence of pterygium after surgical excision.MethodsA retrospective review of patients treated for pterygium recurrence was carried out. Patients with recurrent (secondary) pterygium were treated with multiple weekly intra-lesional injections of 0.1-0.2 ml (2.5-5 mg) 5FU post-operatively depending on the size of the recurrence. The treatment was started within 1 month from the date of recurrence. The time from surgery to start of recurrence, previous treatment modalities, and number of recurrences were documented. The number of injections required to induce arrest of progression and/or regression of vascularity and fleshiness of the pterygium and any complications related to 5FU treatment were examined.ResultsFifteen eyes from 14 patients with recurrent pterygium treated with intra-lesional 5FU injections were analysed. Three of the 15 eyes had undergone a secondary excision and 12 had undergone a primary excision. In all, 93.3% of patients showed regression of the fibrovascular tissue (thickness and vascularity) and arrest of progression following a dose of 0.1-0.2 ml (2.5-5 mg) 5FU. Twelve eyes required three injections or fewer, whereas one patient required eight injections. This beneficial effect was maintained over an average follow-up period of 17 months. No complications from 5FU were observed.Conclusion The use of weekly intra-lesional 5FU injections for the treatment of recurrent pterygium is safe and effective in limiting the progression and inducing the regression of recurrent pterygium. The number of injections can be tailored according to clinical need.Eye advance online publication, 28 June 2013; doi:10.1038/eye.2013.135.
    Eye (London, England) 06/2013; · 1.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this paper, the strictly convex quadratic program (QP) arising in model predictive control (MPC) for constrained linear systems is reformulated as a system of piecewise affine equations. A regularized piecewise smooth Newton method with exact line search on a convex, differentiable, piecewise-quadratic merit function is proposed for the solution of the reformulated problem. The algorithm has considerable merits when applied to MPC over standard active set or interior point algorithms. Its performance is tested and compared against state-of-the-art QP solvers on a series of benchmark problems. The proposed algorithm is orders of magnitudes faster, especially for large-scale problems and long horizons. For example, for the challenging crude distillation unit model of Pannocchia, Rawlings, and Wright (2007) with 252 states, 32 inputs, and 90 outputs, the average running time of the proposed approach is 1.57 ms.
    Automatica 06/2011; 47:2016–2022. · 2.92 Impact Factor
  • [Show abstract] [Hide abstract]
    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.
    International Ophthalmology 02/2012; 32(1):3-8.


Available from
Jun 6, 2014