Trabeculectomy with intraoperative 5-fluorouracil vs mitomycin C

Am J Ophthalmol. 1997 Jan;123(1):48-53. doi: 10.1016/s0002-9394(14)70991-2.


Purpose: To compare the effectiveness of intraoperative 5-fluorouracil (5-FU) and mitomycin C used adjunctively with trabeculectomy in a black West African population.

Methods: Eighty-five consecutive eyes of 85 black patients undergoing primary trabeculectomy for open-angle glaucoma were prospectively randomly assigned to receive either 5-FU (50 mg/ml for 5 minutes) or mitomycin C (0.5 mg/ml for 3 1/2 minutes) intraoperatively by soaked sponge.

Results: Of the 81 eyes with at least a 3-month postoperative follow-up, 41 of 44 (93.2%) in the mitomycin C group and 27 of 37 (73.0%) in the 5-FU group had a final intraocular pressure of less than 21 mm Hg (P = .01). Twenty-eight of 44 eyes (63.6%) in the mitomycin C group and 18 of 37 (51.4%) in the 5-FU group had a final intraocular pressure of less than 15 mm Hg (P = .26). Mean postoperative intraocular pressure was 13.7 mm Hg in the mitomycin C group and 16.3 mm Hg in the 5-FU group (P = .05). There were no differences between the two groups in mean age, preoperative intraocular pressure, postoperative visual acuity, and complications. Mean follow-up was 10.0 +/- 4.41 months (range, 4 to 19 months).

Conclusions: The adjunctive use of mitomycin C with trabeculectomy is equally safe and more efficacious compared to 5-FU in this West African population. Use of mitomycin C in this study was not associated with a statistically significantly greater proportion of patients achieving low intraocular pressure (less than 15 mm Hg) compared to 5-FU.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antimetabolites / adverse effects
  • Antimetabolites / therapeutic use*
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use*
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / drug effects
  • Intraoperative Care
  • Male
  • Middle Aged
  • Mitomycins / adverse effects
  • Mitomycins / therapeutic use*
  • Prospective Studies
  • Trabeculectomy*
  • Treatment Outcome
  • Visual Acuity / drug effects


  • Antimetabolites
  • Mitomycins
  • mitomycin D
  • Fluorouracil