The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium

Alya&agrave; Abood Kareem,1 Qasim Kadhim Farhood,2 Hussein Ali Alhammami11College of Medicine, Kufa University, Najaf, Iraq; 2College of Medicine, University of Babylon, Babylon, Hilla, IraqBackground: Pterygium is a proliferative disease with hyperplastic growth of corneoconjunctival fibro...

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Autores principales:	Kareem AA, Farhood QK, Alhammami HA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d74ddce9854246e09c189c8af5551495
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spelling	oai:doaj.org-article:d74ddce9854246e09c189c8af55514952021-12-02T04:43:40ZThe use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium1177-54671177-5483https://doaj.org/article/d74ddce9854246e09c189c8af55514952012-11-01T00:00:00Zhttp://www.dovepress.com/the-use-of-antimetabolites-as-adjunctive-therapy-in-the-surgical-treat-a11475https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Alya&agrave; Abood Kareem,1 Qasim Kadhim Farhood,2 Hussein Ali Alhammami11College of Medicine, Kufa University, Najaf, Iraq; 2College of Medicine, University of Babylon, Babylon, Hilla, IraqBackground: Pterygium is a proliferative disease with hyperplastic growth of corneoconjunctival fibro vascular tissue onto the cornea. Surgical therapy can be used to successfully manage pterygia; however, recurrence remains a problem. To reduce recurrence, surgical management may include autoconjunctival grafting, lamellar keratoplasty, amniotic membrane transplantation, and intraoperative antimetabolites application.Purpose: To assess the safety and the efficacy of intraoperative mitomycin C (MMC) and 5-fluorouracil (5-FU) application in preventing recurrence of pterygium after excision.Patients and methods: The study design is a prospective, randomized clinical trial. A total of 50 patients with bilateral pterygium were recruited for the study. The first group of patients (25) underwent surgical excision of the pterygium with bare sclera in one eye and MMC was applied as adjunctive therapy for the other eye. In the second group 5-FU was used instead of MMC. Recurrences and postoperative complications were measured in the two groups. The mean follow up period of the patients was 18.8 months. Chi square test, odds ratio, and frequency distribution were used to determine significance levels; P-values &lt;0.05 were considered statistically significant.Results: In group 1 the recurrence rate was 8% for the MMC treated eyes and 32% for their fellow eyes (P = 0.03). In group 2 the rate was 18% for the 5-FU treated eyes and 34% for their fellow eyes (P = 0.07). No serious complications were recorded in either group.Conclusion: Both MMC and 5-FU reduce the recurrence rate of pterygium after simple surgical excision; statistically, the effect of the former was significant, but insignificant for the latter. Both antimetabolites were safe during the whole study period, but 5-FU recurrent cases showed cosmetically unacceptable appearances with excessive vascularization. MMC, but not 5-FU, is recommended as an adjunctive therapy to prevent recurrence of pterygium after surgical excision.Keywords: recurrent pterygium, mitomycin C, 5-fluorouracil, adjunctive therapyKareem AAFarhood QKAlhammami HADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1849-1854 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kareem AA Farhood QK Alhammami HA The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
description	Alya&agrave; Abood Kareem,1 Qasim Kadhim Farhood,2 Hussein Ali Alhammami11College of Medicine, Kufa University, Najaf, Iraq; 2College of Medicine, University of Babylon, Babylon, Hilla, IraqBackground: Pterygium is a proliferative disease with hyperplastic growth of corneoconjunctival fibro vascular tissue onto the cornea. Surgical therapy can be used to successfully manage pterygia; however, recurrence remains a problem. To reduce recurrence, surgical management may include autoconjunctival grafting, lamellar keratoplasty, amniotic membrane transplantation, and intraoperative antimetabolites application.Purpose: To assess the safety and the efficacy of intraoperative mitomycin C (MMC) and 5-fluorouracil (5-FU) application in preventing recurrence of pterygium after excision.Patients and methods: The study design is a prospective, randomized clinical trial. A total of 50 patients with bilateral pterygium were recruited for the study. The first group of patients (25) underwent surgical excision of the pterygium with bare sclera in one eye and MMC was applied as adjunctive therapy for the other eye. In the second group 5-FU was used instead of MMC. Recurrences and postoperative complications were measured in the two groups. The mean follow up period of the patients was 18.8 months. Chi square test, odds ratio, and frequency distribution were used to determine significance levels; P-values &lt;0.05 were considered statistically significant.Results: In group 1 the recurrence rate was 8% for the MMC treated eyes and 32% for their fellow eyes (P = 0.03). In group 2 the rate was 18% for the 5-FU treated eyes and 34% for their fellow eyes (P = 0.07). No serious complications were recorded in either group.Conclusion: Both MMC and 5-FU reduce the recurrence rate of pterygium after simple surgical excision; statistically, the effect of the former was significant, but insignificant for the latter. Both antimetabolites were safe during the whole study period, but 5-FU recurrent cases showed cosmetically unacceptable appearances with excessive vascularization. MMC, but not 5-FU, is recommended as an adjunctive therapy to prevent recurrence of pterygium after surgical excision.Keywords: recurrent pterygium, mitomycin C, 5-fluorouracil, adjunctive therapy
format	article
author	Kareem AA Farhood QK Alhammami HA
author_facet	Kareem AA Farhood QK Alhammami HA
author_sort	Kareem AA
title	The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
title_short	The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
title_full	The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
title_fullStr	The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
title_full_unstemmed	The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
title_sort	use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/d74ddce9854246e09c189c8af5551495
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The use of antimetabolites as adjunctive therapy in the surgical treatment of pterygium

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