Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up

Ophthalmology. 1995 Sep;102(9):1263-9. doi: 10.1016/s0161-6420(95)30875-5.


Purpose: To compare the outcome of filtering surgery in high-risk patients using intraoperative mitomycin C (MMC) versus postoperative 5-fluorouracil (5-FU).

Methods: In a randomized clinical trial, the use of postoperative subconjunctival injections of 5-FU in 19 eyes of 19 patients was compared with a single intraoperative application of MMC in 20 eyes of 20 patients. All eyes were at high risk for failure of glaucoma filtering surgery.

Results: Follow-up ranged from 26 to 38 months (mean, 32.0 months). Three eyes in the MMC-treated group and two eyes in the 5-FU-treated group required subsequent surgery to control the IOP. Excluding these patients, intraocular pressure (IOP) averaged 9.0 +/- 4.9 mmHg in the MMC-treated eyes versus 16.3 +/- 4.6 mmHg in the 5-FU-treated eyes at the patient's last visit (P = 0.0003). Of the MMC-treated eyes, 81.3% had IOPs less than or equal to 12 mmHg compared with 26.7% of eyes in the 5-FU group (P = 0.0023). In the MMC-treated group, the average number of medications for IOP control at last visit was 0.5 +/- 0.8 compared with 1.6 +/- 1.3 in the 5-FU-treated group (P = 0.01). Late postoperative complications (those occurring more than 3 months after surgery) were similar for the two groups, with the exception of formation of a Tenon cyst in three of the eyes treated with MMC compared with none of the 5-FU-treated eyes.

Conclusions: Eyes treated with MMC have lower IOP on fewer medications than eyes treated with 5-FU. Late postoperative complications are similar with the exception of an increased incidence of Tenon cyst formation in the MMC-treated eyes.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antibiotics, Antineoplastic / administration & dosage*
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Chemotherapy, Adjuvant
  • Female
  • Filtering Surgery*
  • Fluorouracil / administration & dosage*
  • Follow-Up Studies
  • Glaucoma / drug therapy
  • Glaucoma / surgery*
  • Humans
  • Injections
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage*
  • Postoperative Complications
  • Treatment Outcome
  • Visual Acuity


  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Mitomycin
  • Fluorouracil