Effects of intraoperative 5-fluorouracil or mitomycin C on glaucoma filtration surgery in the rabbit

Ophthalmology. 1993 Mar;100(3):367-72. doi: 10.1016/s0161-6420(93)31640-4.


Purpose: To establish the effects of single intraoperative exposures to either 5-fluorouracil (5-FU) or two different concentrations of mitomycin C (MMC) on filtration surgery in the rabbit.

Methods: A prospective, randomized, masked-observer, placebo-controlled study was performed to compare the effects on filtration surgery in rabbits of a single 5-minute intraoperative exposure to 5-FU (50 mg/ml), MMC (0.2 mg/ml), or MMC (0.4 mg/ml) with control eyes treated with distilled water.

Results: Intraocular pressures (IOPs) remained lower for longer and bleb survival was increased (P < 0.05) with all three treatments compared with control eyes. The effect of 5-FU was more transient than MMC. Bleb survival was prolonged in the following order: MMC 0.4 > MMC 0.2 > 5-FU 50 mg/ml. At 30 days, blebs were present in 100% of eyes treated with MMC 0.4 mg/ml, 60% of eyes treated with MMC 0.2 mg/ml, and 0% of eyes treated with 5-FU 50 mg/ml or distilled water. The blebs in the eyes treated with MMC were thinner, and significant complications (endophthalmitis, transient corneal opacification and neovascularization, and a presumed bleb leak) only occurred in the eyes treated with MMC 0.4 mg/ml.

Conclusions: The authors' results suggest that 5-FU and MMC at these concentrations, delivered as a single intraoperative dose, prolong the survival of filtration surgery for different lengths of time in the rabbit, which is a model that normally exhibits aggressive healing and rapid failure of filtration surgery. The implications of these potentially titratable effects for filtration surgery in different categories of patients are discussed.

Publication types

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

MeSH terms

  • Animals
  • Double-Blind Method
  • Drug Evaluation, Preclinical
  • Fluorouracil / administration & dosage*
  • Glaucoma / drug therapy*
  • Glaucoma / surgery*
  • Intraocular Pressure
  • Intraoperative Care
  • Mitomycin / administration & dosage*
  • Placebos
  • Prospective Studies
  • Rabbits
  • Random Allocation
  • Trabeculectomy*


  • Placebos
  • Mitomycin
  • Fluorouracil