探讨5-氟尿嘧啶(5-FU)病灶旁结膜下注射治疗早期、活跃期复发性翼状胬肉的临床疗效与安全性，并观察其对已侵入角膜早期病变的逆转潜力。

收集2021年12月至2025年7月于华中科技大学同济医学院附属协和医院眼科确诊并接受治疗的6例(6只眼)早期复发性翼状胬肉患者资料。其中，男性1例(1只眼)，女性5例(5只眼)；年龄25~40岁，平均年龄(34.8±5.5)岁。所有患者均在门诊接受病灶旁结膜下注射5-FU，0.2~0.3 ml/次，每周1次，直至病变进入静止状态。观察治疗前后裂隙灯显微镜下充血程度、角膜侵入范围及新生血管情况，观察活体共聚焦显微镜(IVCM)下上皮形态，采用视觉模拟评分法(VAS)评估眼部异物感、充血感、畏光及流泪等刺激症状。患者年龄、复发时间、注射次数及VAS评分等采用±s描述。性别和疗效判定等分类资料采用频数和百分比(%)描述。

6例(6只眼)患者术后复发时间为3~5.5个月，平均(4.2±1.0)个月。全部患者均完成治疗及随访。6例(6只眼)患者注射2~4次，平均(2.8±0.8)次；随访8~12个月，平均随访时间(9.8±1.5)个月。本研究6例(6只眼)患者治疗后均有效，总有效率100%。其中，5例(5只眼)达到治愈，占83.3%；客观体征上，复发翼状胬肉侵入角膜的结膜上皮及新生血管完全消退，且随访期内保持稳定；自觉症状基本消失，VAS评分≤0.5分。1例(1只眼)有效，占16.7%；客观体征上，充血程度、组织厚度较基线明显好转；随访期内翼状胬肉头部未再向角膜侵犯。治疗前，6例(6只眼)患者VAS评分2~6分，平均为(4.0±1.4)分。经治疗，末次随访时VAS评分0~0.5分，平均降至(0.17±0.26)分，所有患者的眼部刺激症状均明显改善或消失。治疗前后患者的最佳矫正视力均保持在1.0。治疗前眼压12.0~18.7 mmHg(1 mmHg＝0.133 kPa)，平均眼压(15.9±2.4)mmHg；治疗后眼压13.0~19.0 mmHg，平均眼压(16.1±2.3)mmHg，均在正常范围内。IVCM显示，治疗前的高反光增殖上皮在治疗后恢复至正常形态。随访期内，6例(6只眼)患者均未出现角膜上皮缺损、角膜基质溶解、巩膜软化及感染等严重并发症。

对于早期活跃期复发性翼状胬肉，采用5-FU进行病灶旁结膜下注射是一种安全、有效且微创的治疗选择。该疗法不仅能有效地抑制病变进展，显著改善患者症状，且对已侵入角膜的早期病灶具有诱导消退作用，为临床避免再次手术提供了新的干预策略。

The aim of this study is to investigate the clinical efficacy and safety of subconjunctival injection of 5-fluorouracil (5-FU) adjacent to the lesion for the treatment of early-stage, active recurrent pterygium, and observe its potential to reverse early lesions that have already invaded the cornea.

Data were collected from 6 patients (6 eyes) diagnosed with early recurrent pterygium and treated at the Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from December 2021 to July 2025. The cohort included 1 male (1 eye) and 5 females (5 eyes) with a mean age of (34.8±5.5) years (ranging from 25 to 40 years). All patients received outpatient subconjunctival injections of 5-FU (0.2 to 0.3 ml per session) adjacent to the lesion, administered once weekly until the lesion entered a quiescent state. Before and after treatment regarding the degree of congestion under slit-lamp microscopy, the extent of corneal invasion, and neovascularization were observed; epithelial morphology under in vivo confocal microscopy (IVCM); and ocular irritation symptoms including foreign body sensation, congestion sensation, photophobia, and tearing assessed using the visual analogue scale (VAS). The patient′s age, recurrence time, injection frequency, and VAS score were described using ±s. Categorical data such as gender and efficacy assessment were described using frequency and percentage (%).

The postoperative recurrence time for the 6 patients (6 eyes) was a mean of (4.2±1.0) months (ranging from 3 to 5.5 months). All patients completed the treatment and follow-up. The 6 patients (6 eyes) received 2 to 4 injections, with a mean of (2.8±0.8) injections; the follow-up period ranged from 8 to 12 months, with a mean follow-up duration of (9.8±1.5) months. All 6 patients (6 eyes) in this study showed a response to treatment, yielding a total effective rate of 100%. Among them, 5 patients (5 eyes) achieved remission, accounting for 83.3%; objectively, the conjunctival epithelium and neovascularization of the recurrent pterygium invading the cornea completely regressed and remained stable during the follow-up period; subjective symptoms essentially disappeared, with VAS scores ≤0.5. One patient (1 eye) showed improvement, accounting for 16.7%; objectively, the degree of congestion and tissue thickness significantly improved compared to baseline; the pterygium head did not invade further into the cornea during follow-up. Before treatment, the VAS scores of the 6 patients (6 eyes) ranged from 2 to 6 scores, with a mean of (4.0±1.4) scores. After treatment, at the last follow-up, VAS scores ranged from 0 to 0.5 scores, with a mean of (0.17±0.26) scores, indicating that ocular irritation symptoms were significantly improved or resolved in all patients. The best corrected visual acuity of the patients remained at 1.0 before and after treatment. Pre-treatment intraocular pressure ranged from 12.0 to 18.7 mmHg (1 mmHg=0.133 kPa), with a mean of (15.9±2.4) mmHg; post-treatment intraocular pressure ranged from 13.0 to 19.0 mmHg, with a mean of (16.1±2.3) mmHg, both within the normal range. IVCM showed that the highly reflective proliferative epithelium observed before treatment returned to a normal morphology after treatment. During the follow-up period, none of the 6 patients (6 eyes) experienced severe complications such as corneal epithelial defects, corneal stromal melting, scleral softening, or infection.

For early-stage active recurrent pterygium, subconjunctival injection of 5-FU adjacent to the lesion is a safe, effective, and minimally invasive treatment option. This therapy can not only effectively inhibit disease progression and significantly improve patient symptoms but also induce regression in early lesions that have already invaded the cornea, providing a new interventional strategy to avoid reoperation in clinical practice.