Post-operative beta-irradiation in the management of pterygium

Full text: A retrospective analysis of the effectiveness of Sr-90 therapy in post-operative management of pterygium. Between June 1999 and May 2001 a total of 70 patients received beta radiation for treatment of pterygium at the Institute of Nuclear Medicine and Ultrasound, Dhaka. The patients were referred by the eye surgeons soon after excision of the lesion for beta radiation to the affected area. Hand held Sr-90 contact applicator from Amersham International was used to deliver a total dose of 2500 cGy radiation to the sclera surface in five fractions. Care was taken to anesthetize the eye(s) before each application. The patients were then followed up at one week, one month, six months and one-year interval after beta irradiation. The age range of the patients suffering from primary pterygium was 18 to 40 years. All patients underwent surgical excision with bare sclera technique. Of the patients treated 42 patients were completely lost to follow up, while 28 patients were followed up at different periods for up to 12 months. In these patients the local control rate of pterygium after irradiation was 94.6% after 12 months. Recurrence of the pterygium occurred in 5.4% of cases who were given a second course of strontium therapy. Follow- up after six months showed these patients to remain free of the disease. Associated complications were mild and included conjunctivitis. There was improvement of visual acuity in 21 patients with no evidence of cataract or ulceration noted in any of 28 patients during the 12- month follow-up period. In conclusion, beta irradiation with Sr-90 after surgical excision of pterygium was found to be a safe and cost-effective means of controlling the recurrence rate of pterygium. (author)