A prospective trial of intraoperative fluorouracil during trabeculectomy in a black population

Am J Ophthalmol. 1993 Nov 15;116(5):612-6. doi: 10.1016/s0002-9394(14)73204-0.

Abstract

In a study population of black Africans with advanced glaucoma in Ghana we conducted a prospective study of intraoperative 5-fluorouracil alone. Eyes undergoing trabeculectomy were randomly selected either to receive or not receive a single intraoperative application of 5-fluorouracil (50 mg/ml for five minutes). Fifty-five eyes had a mean follow-up of 282 days (minimum, 92 days). Twenty of 24 eyes (83%) in the 5-fluorouracil group vs 12 of 31 eyes (39%) in the control group had postoperative intraocular pressure of 20 mm Hg or less with or without medical therapy (P = .01). Eleven of 24 eyes (46%) in the 5-fluorouracil group and five of 31 eyes (16%) in the control group had intraocular pressure of 15 mm Hg or less (P = .02). Without medical therapy, 17 of 24 eyes (71%) in the 5-fluorouracil group and ten of 31 eyes (32%) in the control group had intraocular pressure of 20 mm Hg or less (P = .02). The overall complications were similar in the two groups. In this population, intraoperative 5-fluorouracil markedly improved the ability of trabeculectomy to lower intraocular pressure. We recommend that intraoperative 5-fluorouracil be considered in glaucoma surgery with poor prognosis as an alternative to postoperative subconjunctival injections when multiple injections are not feasible.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Continental Ancestry Group
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorouracil / administration & dosage*
  • Fluorouracil / therapeutic use
  • Follow-Up Studies
  • Ghana
  • Glaucoma, Angle-Closure / drug therapy
  • Glaucoma, Angle-Closure / ethnology
  • Glaucoma, Angle-Closure / surgery*
  • Glaucoma, Open-Angle / drug therapy
  • Glaucoma, Open-Angle / ethnology
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Intraoperative Period
  • Male
  • Middle Aged
  • Prospective Studies
  • Trabeculectomy*

Substances

  • Fluorouracil