Pterygium Excision Using Bare Sclera Technique and Adjunctive 5-Fluorouracil Application

Pterygium is worldwide pathological condition especially affecting those who live in hot, dry climates like Iraq, multiple treatment options are available for this condition, the surgeon and sometimes the patient has to choose one of them.

To evaluate the efficacy and safety of low-dose intraoperative 5-Flourouracil during bare sclera procedure and to compare the rates of recurrence for this technique in comparison with other techniques used for pterygium excision.

47 eyes of 47 patients (of different ages and sexes), underwent pterygium excision with bare sclera technique and adjunctive use of low-dose intraoperative 5-Fluorouracil applied on the sclera at the base of removed pterygium for 5 minutes, patients were evaluated for complications and recurrence over a period ranging from 24–84 months(mean follow up time was 43 month).

Different complications were reported in the patients during the follow up period, the complications reported are relatively few and less serious when compared to that associated with other techniques used for pterygium excision, the overall recurrence rate of pterygium in this study was 12.76% (6 patients from 47 patients included in this study develop recurrence) (P value <0.001), the recurrence rate in those operated for primary pterygium was 8.10% (3 patients from 37 patients who had primary pterygium) (P value <0.001), while the recurrence rate in those operated for recurrent pterygium was 30% (3 patient from 10 patients who had initially recurrent pterygium) (P value >0.05). No patients develop serious sight threatening complication on long term follow up.

Pterygium excision with bare sclera technique and adjunctive application of low-dose intraoperative 5-Fluorouracil is a safe and effective technique for patients suffering from primary pterygium with a very low recurrence rate especially in patients above 50 years old, but using this technique for treatment of recurrent pterygium has no such low recurrence rate (but still have less complications and/or better cosmetic appearance when compared to other techniques).