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Strategies for management of recurrent pterygium

  • Research type

    Research Study

  • Full title

    Management of recurrent pterygium to prevent visual impairment(REPEAT)

  • IRAS ID

    186823

  • Contact name

    Harminder Dua

  • Contact email

    harminder.dua@nottingham.ac.uk

  • Sponsor organisation

    University of Nottingham

  • Eudract number

    2015-003217-20

  • Clinicaltrials.gov Identifier

    NCT02530801

  • Duration of Study in the UK

    2 years, 8 months, 30 days

  • Research summary

    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.

  • REC name

    East Midlands - Nottingham 2 Research Ethics Committee

  • REC reference

    16/EM/0002

  • Date of REC Opinion

    14 Mar 2016

  • REC opinion

    Further Information Favourable Opinion