Bekibele Charles O, Ashaye Adeyinka, Olusanya Bolutife, Baiyeroju Aderonke, Fasina Oluyemi, Ibrahim Adekunmi O, Ogun Olufunmi
Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
Int Ophthalmol. 2012 Feb;32(1):3-8. doi: 10.1007/s10792-011-9509-x. Epub 2012 Jan 15.
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.
比较5-氟尿嘧啶（5-FU）与丝裂霉素C（MMC）在翼状胬肉切除联合结膜自体移植术后作为辅助用药预防翼状胬肉复发的疗效。低剂量MMC联合结膜自体移植是预防翼状胬肉切除术后复发的有效治疗方法，但安全性、成本和可及性限制了其在发展中国家的应用。关于5-FU在非洲作为翼状胬肉切除术后结膜自体移植辅助用药的疗效数据较少。这是一项使用50mg/ml 5-FU或0.01% MMC的随机对照前瞻性试验。对80名受试者的80只眼睛进行了研究。46名平均年龄为49.8±13.8岁的受试者接受了5-FU治疗（每单位13.0美元），而34名平均年龄为51.9±12.1岁的患者接受了MMC治疗（每单位20.0美元）。两组的平均年龄无显著差异（p = 0.48）。5-FU组男女患者比例为0.92:1，MMC组为1:1，两组相似（p = 0.85）。平均随访期为35.2±29.1周。5-FU组的复发率为8.7%，而MMC组为11.8%（复发风险比=0.71，95%可信区间0.17-3.1，p = 0.7）。MMC治疗组有1例患者发生角膜巩膜融解。其他并发症较轻，不威胁视力。在预防翼状胬肉复发方面，5-FU在翼状胬肉切除联合结膜自体移植术后作为辅助用药时，似乎与低剂量MMC效果相当。需要进一步研究评估在这类病例中使用5-FU的长期效果。
