5-fluorouracil and glaucoma filtering surgery. II. A pilot study

Ophthalmology. 1984 Apr;91(4):384-94. doi: 10.1016/s0161-6420(84)34291-9.

Abstract

5-Fluorouracil (5-FU) was injected subconjunctivally after glaucoma filtering surgery in a pilot study of eyes with poor surgical prognoses. Twenty-seven (79%) of the 34 aphakic eyes with glaucoma achieved an intraocular pressure (IOP) of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 91 -468 days). Nine (69%) of 13 eyes with neovascular glaucoma achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 120-379 days). Eight (89%) of nine phakic eyes with glaucoma following unsuccessful filtering procedures achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 134-394 days). Visual acuities remained within one line of their preoperative levels or improved in 32 (94%) of the 34 aphakic eyes with glaucoma, eight (62%) of the 13 eyes with neovascular glaucoma, and six (67%) of the nine phakic eyes with glaucoma following unsuccessful filtering procedures. Postoperative corneal epithelial defects occurred in 45% of the cases. Conjunctival wound and conjunctival needle tract leaks were observed in 41% of the cases, but only one eye required wound revision. No other serious side effects that we attributed to 5-FU were observed. It seems that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control following filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cataract Extraction
  • Child
  • Cicatrix / prevention & control*
  • Combined Modality Therapy
  • Dose-Response Relationship, Drug
  • Fibroblasts / drug effects
  • Fluorouracil / therapeutic use*
  • Follow-Up Studies
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / drug effects
  • Laser Therapy
  • Middle Aged
  • Neovascularization, Pathologic / surgery
  • Pilot Projects
  • Postoperative Care
  • Postoperative Complications / surgery
  • Visual Acuity / drug effects

Substances

  • Fluorouracil