Role of Intralesional 5-Flourouracil as Primary Treatment of Early Pterygium

Objective: The primary objective of this study was to assess the impact of intralesional 5-FU in early stage pterygium in terms of size reduction, visual acuity improvement, intraocular pressure and efficacy of 5-FU. Study Design: Quasi experimental study. Place and Duration of Study: Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Jun 2024 to May 2025. Methodology: The study included 130 patients diagnosed with early-stage pterygium, treated with a single dose of intralesional 5-FU and follow-up assessments conducted at 1week, 1 month, 3 months and 6 months. Follow-up assessments included pterygium size, visual acuity, intraocular pressure and slit-lamp examination. Results: The study included 130 participants with a mean age of 45.2±10.1 years, with 53.8% aged 45 years or younger. The gender distribution was nearly equal (53.8% males and 46.2% females). Most participants (73.1%) had unilateral pterygium, and 60% had Grade 1 pterygium. Treatment with intralesional 5-FU resulted in a significant reduction in pterygium size (3.1±1.2 mm pre-treatment to 2.0±0.8 mm post-treatment, p<0.001). Visual acuity improved from a pre-treatment log MAR score of 0.25±0.18 to 0.18±0.14 post-treatment (p=0.02). Efficacy was observed in 85.31% of patients, with higher efficacy in younger males and those with Grade 1 pterygium (p<0.001). Conclusion: Intralesional 5-FU is an effective and safe primary treatment for early-stage pterygium, demonstrating significant reduction in lesion size and low recurrence rates. Further studies with longer follow-up and control groups are needed to validate these findings.