Photodynamic therapy for wound-healing modulation in pterygium surgery. A clinical pilot study

Background: This study was performed to evaluate the safety and efficacy of photodynamic therapy with the carboxyfluorescein ester BCECF-AM as an adjunctive treatment procedure for pterygium surgery to reduce the rate of recurrence. Methods: In this nonrandomized prospective clinical trial, 19 eyes with nasally located primary pterygium were examined. All eyes were treated with the bare sclera surgical technique. Seven eyes received in addition treatment with BCECF-AM solution and blue light. All patients were evaluated at least after 1 day, 1 week, 1 month, 3 months, and 1 year. Postoperative fibrovascular growth from the limbus of at least 1 mm was defined as recurrence. Results: The intraoperative application of BCECF-AM solution did not cause anterior chamber flare or any other significant side effects. The bare sclera surgery rate of recurrence was 0% (zero of 12) after 3 months and 91% (11 of 12) after 1 year. The additional photodynamic therapy treatment had a rate of recurrence of 14.2% (one of seven) after 3 months and 71.4% (five of seven) after 1 year. Conclusions: The applied PDT technique seems to be a safe procedure but is associated with a high rate of recurrence. In conclusion, the evaluated PDT treatment procedure, at this point, should not be considered. As we found a high rate of recurrence also in the control group, the bare sclera technique is not effective, even in primary pterygia.