Postoperative 5-fluorouracil versus intraoperative mitomycin C in high-risk glaucoma filtering surgery: extended follow up

Clin Exp Ophthalmol. 2003 Jun;31(3):199-205. doi: 10.1046/j.1442-9071.2003.00645.x.


Purpose: To compare the long-term efficacy and safety of postoperative subconjunctival 5-fluorouracil (5-FU) injections with that of intraoperative mitomycin C (MMC) in eyes at high risk for failure of trabeculectomy.

Methods: In a retrospective, non-randomized comparative trial, 36 eyes of 36 consecutive patients at high risk for failure of trabeculectomy underwent glaucoma filtering surgery with either postoperative subconjunctival 5-FU injections (19 eyes) or intraoperative application of MMC (17 eyes). Intraocular pressure, number of postoperative antiglaucoma medications, postoperative visual acuity, interventions, and complications were evaluated.

Results: Overall success (intraocular pressure </=21 mmHg) at 1 year was 73.6% in the 5-FU group and 82.3% in the MMC group. The cumulative 4-year success was 52.6% in the 5-FU group and 60.5% in the MMC group (P = 0.6). At 4-year follow up, mean +/- SD intraocular pressures were 17.58 +/- 4.01 mmHg in the 5-FU group and 13.33 +/- 3.36 mmHg in the MMC group (P = 0.01). There was no significant difference in the number of post-operative medications (P = 0.84), appearance of blebs (P = 0.20), final visual acuity (P = 1.00), and complications (P > 0.05) between the groups.

Conclusions: These results suggest that both postoperative 5-FU injections and intraoperative MMC application have long-term success in high-risk patients. However, MMC results in a greater decrease in intraocular pressure than 5-FU.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Filtering Surgery* / adverse effects
  • Fluorouracil / therapeutic use*
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / drug effects
  • Intraoperative Care*
  • Male
  • Middle Aged
  • Mitomycin / therapeutic use*
  • Preoperative Care*
  • Retrospective Studies
  • Visual Acuity


  • Mitomycin
  • Fluorouracil