5-fluorouracil vs. beta-irradiation in the prevention of pterygium recurrence

ABSTRACT The aim of this study was to compare 5-fluorouracil

(5-FU) with beta-irradiation in the prevention of pterygium

recurrence.

Materials and methods: A retrospective non-randomised

review of cases of fleshy prcrygium treated with bare scleral

excision and adjuvant 5-FU were compared with similar

morphologically appearing prcrvgiu, marched for age and

sex, treated with bare scleral excision and adjuvant berairradiariou.

All surgeries were carried our ar the university

college hospital and () julowo eve hospital, Ibadan, Nigeria.

Results: Twcnrv-scvcn eyes of 24 patients who had

prer:'gium excision wirh adjuvanr rrcarmcnr with 5-FU

were compared wirh 31 eyes of 24 patients who were

treated wirh excision and beta-irradiation. Thc mean agc

for rhc 5-FU group was 46.1 vcars while rhar for rhc betairradiarion

group was 46.9 ycars. Borh sexes were cquallv

represented, 12 males and 12 fcmales. There were seven

(2'i.9%) initial recurrences in rhc 5-FU group bur four. of

these became atrophic, and rhcrctorc, cosmetically acccptable

lea'ing duel' eTS (11 %) with unacceptable recurrent

prl'r:·gi

(22.5) inirial recurrence bur five of these became atrophic

and fell shorr of rhc cornea, leaving rwo (6.5%) with

clinicallv unacceptable recurrence. The diflcrcncc was,

however, nor srarisricallv significanr (Zc = 0.-4 and

p > 0.1). The associated complications were mosrlv mild

in borh groups and included cornea opacirv of 10 (,-;-00)

complicarions, co njuncriviris of three (11 Oil) complicario

ns, 'sclera granuloma of three (110'0) coruplicarious

and conjuncriva necrosis of one (3.-%) complicarion for

rhc 5-FU group, and while rhc bcm-irradiation gwup

had corneal opacirv of OIlC (3.-~·0) cornplicarion and

conjuncriviris of three (11 %ll complicarions.

Conclusion: The no n-srarisrical significance of a 1ovv crprcrigium

recurrence rare with use of bcra-irradiarion for

rhe rrcarmcnr of flesh:' prcrvgiurn compared with 'i-FlT

ma:' have been pard:' due ro rhc small number of patients

studied. A rando miscd-courrollcd srudy using a larger

sample size is therefore proposed. However, the facr rhar

over half of rhosc wirh inirial recurrence in the 5-FU group

became atrophic (and therefore cosmcricallv acccprabic)

over rime as well as less cosr implicarion in rhc purchase

of 5-FU relative ro Srronrium-90 associarion with fc-wand

mild complicarions makes ir a desirable adjuvant rhcrapv in

depressed economics. However, bcra-irradiariou still has a

place when cosr issue is nor an inhibiring facwr in view nf

its clinically superior outcome.