THE USE OF COMBINED MINIMALLY INVASIVE SURGERY IN THE TREATMENT OF RECURRENT PTERYGIUM
DOI:
https://doi.org/10.54890/1694-8882-2025-3-148Abstract
Pterygium, or wing-shaped membrane, is one of the most common eye diseases, especially prevalent in regions with high levels of ultraviolet radiation. In Central Asia, this disease affects between 1% and 6% of the total population, which allows this region to be classified as part of the so-called “pterygium belt,” located approximately within ±40˚ of the equator. Pterygium accounts for a significant proportion of eye diseases in our country — in urban areas, it ranges from 2% to 2.5%, which highlights the importance of finding effective treatment methods. The aim of the study was to evaluate the effectiveness of minimally invasive surgery in combination with 5- fluorouracil in the treatment of recurrent forms of pterygium. The study included 11 patients (11 eyes) with recurrent pterygium stages I–III. All patients underwent standard ophthalmological examinations to assess their initial condition and dynamics after the intervention. The combined treatment technique used included standard mini autoconjunctival plasty, during which an anesthetic and 5-fluorouracil were administered to the autograft area prior to flap excision to increase the effectiveness of the procedure. No serious complications were recorded during the intraoperative and postoperative periods, which indicates the safety of the method used. In all operated patients, visual acuity in the postoperative period ranged from 0.6 to 1.0, and the remaining ophthalmological indicators remained within normal limits. The new method of combined minimally invasive pterygium surgery that we have proposed has proven to be highly effective and safe and has provided excellent cosmetic results, which gives us reason to recommend it for widespread use in clinical practice.
Keywords:
pterygium, 5-fluorouracil, autoconjunctiva, graft, recurrence, pterygium, surgeryReferences
1. Тришкин К.С. Новый способ хирургического лечения птеригиума. Сборник тезисов XVII региональной конференции молодых исследователей Волгоградской области. 2012:68–70.
2. Банщиков П.А., Егоров В.В., Смолякова Г.П., Бочкарева А.Н. Повышение эффективности хирургического лечения рецидивирующего птеригиума. Современные технологии в офтальмологии. 2015;2:141–144.
3. Черединченко ЛП, Коренек ГВ, Жигенко НА. Роль эколого–географических факторов в развитии птеригиума. Медицинский вестник Северного Кавказа. 2006;2:56–57.
4. Бикбов М.М., Суркова ВК, Казакбаев РА. Региональные особенности эпидемиологии птеригиума в Республике Башкортостан. Acta Biomedica Scientifica. 2022;7(1):82–89. https://doi.org/10.29413/ABS.2022-7.1.10
5. Cabral-Pacheco GA, Garza-Veloz I, Castruita-De la Rosa C, et al. The Roles of Matrix Metalloproteinases and Their Inhibitors in Human Diseases. Int J Mol Sci. 2020;21(24):9739. https://doi.org/10.3390/ijms21249739
6. Chen S, Zhang M, Lin Y, Shi Y, Lin Q, Xie T, et al. Risk factors for pterygium recurrence based on a retrospective study of 196 patients. Sci Rep. 2025 Feb 24;15(1):6646. https://doi.org/10.1038/s41598-025-90433-1
7. Бочкарева А.Н., Егоров В.В., Смолякова Г.П., Коленко О.В., Банщиков П.А. Оценка эффективности нового комбинированного метода лечения первичного прогрессирующего птеригиума. Современные технологии в офтальмологии. 2021;1:221-225. https://doi.org/10.25276/2312-4911-2021-1-221-225
8. Тургунбаев Н.А., Островерхов А.И., Шиваза Ф.Р. Сравнительная характеристика применения различных методов хирургического лечения птеригиума в сочетании с 5-фторурацилом. Вестник КРСУ. 2023;23(9):94–97. https://doi.org/ 10.36979/1694-500X-2023-23-9-94-97
9. Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016;2(2):CD011349. https://doi.org/10.1002/ 14651858.CD011349.pub2
10. Hirst LW. The treatment of pterygium. Surv Ophthalmol. 2003;48(2):145–180. https://doi.org/10.1016/s0039-6257(02)00463-0
11. Youngson RM. Recurrence of pterygium after excision. Br J Ophthalmol. 1972;56(2):120–125. https://doi.org/ 10.1136/bjo.56.2.120
12. Kenyon KR, Wagoner MD, Hettinger ME. Conjunctival autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 1985;92(11):1461–1470. https://doi.org/10.1016/s0161-6420(85)33831-9
13. Koranyi G, Seregard S, Kopp ED. Intraoperative mitomycin C to prevent recurrence of pterygium surgery: 13 years’ experience. Acta Ophthalmol Scand. 2005;83(3):298–301.
14. Alsarhani W, Alshahrani S, Showail M, Alhabdan N, Alsumari O, Almalki A, et al. Characteristics and recurrence of pterygium in Saudi Arabia: a single center study with a long follow-up. BMC Ophthalmol. 2021;21(1):207. https://doi.org/10.1186/s12886-021-01960-0
15. Lee BWH, Sidhu AS, Francis IC, Coroneo MT. 5-Fluorouracil in primary, impending recurrent and recurrent pterygium: Systematic review of the efficacy and safety of a surgical adjuvant and intralesional antimetabolite. Ocul Surf. 2022;26:128-141. https://doi.org/10.1016/j.jtos.2022.08.002.
16. Almond MC, Dastrup BT, Kaufman SC. 5-fluorouracil and mitomycin C: adjuncts to pterygium surgery. In: Hovanesian JA, ed, Pterygium: Techniques and Technologies for Surgical Success. Thorofare, NJ: Slack Inc; 2012:55–64. https://doi.org/10.1201/9781003526094
17. Pikkel J, Porges Y, Ophir A. Halting pterygium recurrence by postoperative 5-fluorouracil. Cornea. 2001; 20:168–171. https://doi.org/10.1097/00003226-200103000-00011
18. Kim YJ, Rao R, Lee HJ. Comparison of surgical techniques for recurrent pterygium. Can J Ophthalmol. 2023;58(5):422-425. https://doi.org/10.1016/ j.jcjo.2022.05.011
19. Shah SU, Ahmed T, Badar A, Shafique M, Malik S, Aaqil B. Efficacy of 5-Fluorouracil in the Treatment of Pterygium. Cureus. 2021;13(1):e12652. https://doi.org/10.7759/cureus.12652
20. Prabhasawat P, Tesavibul N, Leelapatranura K, Phonjan T. Efficacy ofsubconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium. Ophthalmology 2006;113:1102–1109. https://doi.org/10.1016/ j.ophtha.2006.02.026
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