Topical indomethacin solution versus dexamethasone solution for treatment of inflamed pterygium and pinguecula: A prospective randomized clinical study

PURPOSE: To compare the effect of topical indomethacin 0.1% solution with t he effect of topical dexamethasone 0.1% phosphate solution on signs and sym ptoms of inflamed pterygium and pinguecula. METHODS: Of 50 consecutive patients who had inflamed pterygia (n = 17) or p ingueculae (n = 33), met the study criteria, and signed an informed consent , one eye of each patient was evaluated in a comparative, prospective, rand omized, double masked, controlled study. Objective signs (conjunctival cong estion, redness and edema, and staining of cornea) and subjective com plain ts (photophobia, pain, foreign-body sensation, dis comfort, and tearing) we re evaluated and scored. We also evaluated "total signs," "total symptoms," and "total score." Group 1 (n = 25) received topical indomethacin 0.1% sol ution, and group 2 (n = 25) received a topical dexamethasone phosphate 0.1% solution six times daily for 3 days, then four times daily over the follow ing 11 days. Patients were examined before treatment, on days 3, 7, and 14 after the treatment was initiated, and 2 and 4 weeks after the treatment wa s discontinued. RESULTS: In both groups, the scores for "total signs," "total symptoms," an d "total score" were significantly lower (P = .001) by day 14. There were n o differences between groups 1 and 2 for "total signs," "total symptoms," a nd "total score" at days 3, 7, and 14 (P = .07 to P = .88). After treatment was discontinued, the dexamethasone-treated group experienced a significan tly greater recurrence of "total signs" (P = .023 at day 30, P = .02 at day 45), but there was no statistically significant difference in "total sympt oms" and "total score." Patients in group 2 reported more stinging after dr ops were administered than patients in group 1 (P = .002). CONCLUSIONS: This study indicates that topical indomethacin 0.1% solution i s as effective as topical dexamethasone phosphate 0.1% solution for the tre atment of inflamed pterygium and pinguecula and, therefore, is suggested as an effective treatment for these conditions. (Am J Ophthalmol 1999;127:148 -152, (C) 1999 by Elsevier Science Inc. All rights reserved.)