Pterygium is a common eye disease. Its mechanism remains unknown but studies suggest that it
is related to exposure to ultraviolet rays and ocular dryness. Pterygium affects vision by
causing astigmatism and may encroach on cornea (transparent part of the eye) affecting
vision. It could cause ocular irritation and can be cosmetically unacceptable especially when
inflamed.
Recurrence is the most common outcome of pterygium excision. Recurrence rates of pterygium
vary from 10 to more than 80%. Recurrence can be detected first in the conjunctiva(skin of
your eye), before advancing on to the cornea. Treating the recurrent pterygium before the
cornea gets involved avoids repeat surgery, which is difficult and is associated with more
scarring. To avoid repeated surgeries, the activity of a recurrent pterygium should be
stopped before it progresses to true recurrence.
Several studies attributed the recurrence pf pterygium to the increase of substances as
vascular endothelial growth factor(VEGF) and fibroblast growth factor. Avastin (Anti-VEGF)
and 5 fluorouracil(5FU) (antimetabolite) are medications that suppress the formation of VEGF
and fibroblast growth factor.
Studies have shown that the subconjunctival injection of 5 F and Avastin into the recurring
pterygium has been both safe and effective in treatment of recurrent pterygium.
In many cases, vascularization and inflammation were controlled by subconjunctival Avastin,
providing evidence for a role of VEGF in pterygium formation. 5FU is widely used in
ophthalmology because of its anti-scarring properties.
The other option for treatment of recurrent pterygium is surgery. Recurrent pterygium is a
challenging condition that usually resists conventional surgery and its rate of recurrence
after surgery is high. Moreover, recurrent pterygium surgery is usually accompanied by
scarring, more risk of intra and post- complications This study aims to generate data to
inform further studies towards establishing Avastin and 5 fluouracil as treatment modality
for recurrent pterygium.