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Prospective Study of Exclusive Strontium-/Yttrium-90 β-Irradiation of Primary and Recurrent Pterygia with No Prior Surgical Excision

Clinical Outcome of Long-Term Follow-Up

Prospektive Studie zur Behandlung des primären und rezidivierenden Pterygiums nach ausschließlicher Strontium-/Yttrium-90-Bestrahlung. Klinisches Ergebnis im Langzeitverlauf

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Purpose:

To evaluate the consecutive treatment results regarding pterygium recurrence and the efficacy of exclusive strontium-/ yttrium-90 β-irradiation for primary and recurrent pterygia and to analyze the functional outcome.

Patients and Methods:

Between October 1974 and December 2005, 58 primary and 21 recurrent pterygia were exclusively treated with strontium-/yttrium-90 β-irradiation with doses ranging from 3,600 to 5,500 cGy. The follow-up time was 46.6 ± 26.7 months, with a median of 46.5 months.

Results:

The treatment led to a size reduction in all pterygia (p < 0.0001). Neither recurrences nor side effects were observed during therapy and follow-up in this study. Best-corrected visual acuity increased (p = 0.0064). Corneal astigmatism was reduced in recurrent pterygia (p = 0.009).

Conclusion:

Exclusive strontium-/yttrium-90 β-irradiation of pterygia is a very efficient and well-tolerated treatment, with remarkable aesthetic and rehabilitative results in comparison to conventional treatments, especially for recurrent lesions which have undergone prior surgical excision.

Ziel:

Evaluation der Behandlungsergebnisse in Bezug auf Rezidivrate, Effizienz und Funktion der ausschließlichen Strontium-/ Yttrium-90-β-Bestrahlung von primären und rezidierenden Pterygien. Analyse des kornealen und des refraktiven Astigmatismus im Vergleich zu den postoperativen Ergebnissen konventioneller Behandlungsmethoden.

Patienten und Methodik:

Zwischen Oktober 1974 und Dezember 2005 wurden 58 primäre und 21 rezidivierende Pterygien mit ausschließlicher Strontium-/Yttrium-90-β-Bestrahlung mit Dosen von 3 600–5 500 cGy behandelt. Die mittlere Nachbeobachtungszeit betrug 46,6 ± 26,7 Monate, median 46,5 Monate.

Ergebnisse:

Die Behandlung führte bei allen Pterygien zu einer Größenabnahme (p < 0,0001). Es wurden keine Rezidive und keine unerwünschten Nebenwirkungen beobachtet. Die bestkorrigierte Sehschärfe stieg signifikant an (p = 0,0064), der korneale Astigmatismus verkleinerte sich signifikant bei den rezidivierenden Pterygien (p = 0,009).

Schlussfolgerung:

Die ausschließliche Strontium-/Yttrium-90-β-Bestrahlung des Pterygiums ist eine sehr effiziente und gut tolerierte Behandlungsmethode mit einem bemerkenswerten ästhetischen und rehabilitativen Resultat in Vergleich zu den konventionellen Behandlungskonzepten, vor allem bei rezidivierenden Pterygien nach primärer operativer Exzision.

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Authors and Affiliations

  1. Ophthalmology Clinic Pallas, Olten, Switzerland

    Iraklis Vastardis MD

  2. Swiss Eye Research Foundation – ORASIS Eye Clinic, Reinach, Switzerland

    Bojan Pajic & Brigitte Pajic-Eggspuehler

  3. Radiooncology, Cantonal Hospital Luzern, Luzern, Switzerland

    Richard H. Greiner

  4. Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland

    Daniel M. Aebersold

  5. Ophthalmology Clinic Pallas, Louis-Giroud-Straße 20, 4600, Olten, Switzerland

    Iraklis Vastardis MD

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  1. Iraklis Vastardis MD
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  2. Bojan Pajic
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  3. Richard H. Greiner
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Correspondence to Iraklis Vastardis MD.

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Vastardis, I., Pajic, B., Greiner, R.H. et al. Prospective Study of Exclusive Strontium-/Yttrium-90 β-Irradiation of Primary and Recurrent Pterygia with No Prior Surgical Excision. Strahlenther Onkol 185, 808–814 (2009). https://doi.org/10.1007/s00066-009-2000-1

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